A life course approach to cardiovascular disease

Cardiovascular disease remains an important health challenge with high prevalence across the globe. This chapter acknowledges the importance of key adult risk factors including the classic cardiovascular risk factors and, for women, reproductive characteristics, but focusses on the pre-adult period. It details the relevance of understanding early-life trajectories of the classic risk factors, providing examples for blood pressure and lipids, and discussing the methodological challenges. The evidence relating early-life factors, such as physical growth, and social and environmental exposures, to cardiovascular disease is reviewed and highlights how new approaches in epidemiology have added to the evidence from observational studies to further understanding of causal processes. The chapter finishes by considering new risks, such as COVID-19 and climate change, that will need to be integrated within a life course approach and the policy considerations for early-life intervention.