Temporal Trends and Familial Clustering of Ideal Cardiovascular Health in Parents and Offspring Over the Life Course: An Investigation Using The Framingham Heart Study

Background Evidence suggests familial aggregation and intergenerational associations for individual cardiovascular health (CVH ) metrics. Over a 53‐year life course, we examined trends and association ofCVH between parents and their offspring at similar mean ages.Methods and Results We conducted a series of cross‐sectional analyses of the FHS (Framingham Heart Study). Parent‐offspring pairs were assessed at exams where their mean age distributions were similar. IdealCVH was defined using 5CVH metrics: blood pressure (<120/<80 mm Hg), fasting blood glucose (<100 mg/dL ), blood cholesterol (<200 mg/dL ), body mass index (<25 kg/m2 ), and non‐smoking. Joinpoint regression and Chi‐squared test were used to assess linear trend; proportional‐odds regression was used to examine the association between parents and offspringCVH . A total of 2637 parents were paired with 3119 biological offspring throughout 6 exam cycles. Similar patterns of declining idealCVH with advancing age were observed in parents and offspring. Small proportions of parents (4%) and offspring (17%) achieved 5CVH metrics at ideal levels (P ‐trend <0.001). Offspring of parents with poorCVH had more than twice the odds of having poorCVH (pooled odds ratio, 2.59; 95%CI, 1.98–3.40). Over time, elevated glucose levels and obesity doubled among the offspring and were the main drivers for declining idealCVH trends.Conclusions ParentalCVH was positively associated with offspringCVH . However, intergenerationalCVH gains from declining smoking rates, cholesterol, and blood pressure were offset by rising offspring obesity and elevated glucose levels. This suggests an intergenerational phenotypic shift of risk factors and the need for a family‐centered approach to cardiovascular care.