Body size at birth and coronary heart disease-related hospital care in adult men – findings from the Helsinki Birth Cohort Study

Abstract

Aim: We investigated, among those who had been hospitalized at least once due to coronary heart disease (CHD), the relationship between ponderal index (PI, birthweight/length³) at birth, a measure of thinness, and the age at first hospitalization due to CHD, the number of CHD-related hospital care episodes, and cost of CHD-related hospital care from young adulthood to old age.

Methods and results: Data from the Helsinki Birth Cohort Study included 964 men born in Helsinki, Finland during 1934–1944, who had been hospitalized due to CHD and had birth anthropometrics data. PI (kg/m³) was categorized into low (<25.0), medium (25.0–27.5), and high (>27.5). CHD-related hospital care data were available from 1971 to 2013. We observed an earlier onset of (p = .014 for linearity) and a higher rate of CHD-related hospital care episodes among those in the lowest PI group (incidence rate ratio: 1.35 [95% confidence interval: 1.16–1.59, p < .001]), compared to the highest PI group. CHD-related hospital care costs in the lowest PI group were 25% (p = .001, 4% to 46%) higher compared to those in the highest PI group.

Discussion: Thinness at birth is associated with earlier onset, higher prevalence, and higher accumulated costs of CHD-related hospital in-patient care among men who developed CHD.

KEY MESSAGES

• Findings from this large birth cohort indicate that the onset of coronary heart disease (CHD)-related hospital in-patient care occurred at younger age during the 42-year time period among men who were born thin.

• Lower ponderal index (PI) was associated with a higher rate of CHD-related hospital in-patient care during the time period. We observed a linear increase in CHD-related hospital in-patient care costs across PI groups.

Keywords:

• Age of onset
• aging
• birthweight
• cardiovascular disease
• coronary heart disease

Disclosure statement

J.M. is a partner of ESiOR Oy, which carries out health economic and outcome research studies for pharmaceutical and food companies.

Funding

HBCS was supported by Emil Aaltonen Foundation, Finnish Foundation for Diabetes Research, Novo Nordisk Foundation, Signe and Ane Gyllenberg Foundation, Samfundet Folkhälsan, Finska Läkaresällskapet, Liv och Hälsa, Finnish Foundation for Cardiovascular Research. The Academy of Finland supported MEvB [grant No. 250681, 294530], MBvB [grant No. 294530], EK [grant No. 127437, 129306, 130326, 134791, and 2639249], and JGE [grant No. 129369, 129907, 135072, 129255, and 126775]. Folkhälsan Research Center has supported MEvB and MBvB. The research leading to these results has received funding from the European Commission within the 7th Framework Programme (DORIAN, grant agreement no 278603) and EU H2020-PHC-2014-DynaHealth grant no. 633595.