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Background  Economic literature shows that a child's future earnings are predictably influenced by parental income, providing an index of “socioeconomic mobility,” or the ability of a person to move towards a higher socioeconomic status from childhood to adulthood. We adapted this economic paradigm to examine cardiovascular risk mobility ( CRM ), or whether there is life course mobility in relative cardiovascular risk.    Methods and Results  Participants from the BHS (Bogalusa Heart Study) with 1 childhood and 1 adult visit from 1973 to 2016 (n=7624) were considered. We defined population‐level  CRM  as the rank‐rank slope (β) from the regression of adult cardiovascular disease ( CVD ) risk percentile ranking onto childhood  CVD  risk percentile ranking (β=0 represents complete mobility; β=1 represents no mobility). After defining and measuring relative  CRM , we assessed its correlation with absolute cardiovascular health using the American Heart Association's Ideal Cardiovascular Health metrics. Overall, there was substantial mobility, with black participants having marginally better  CRM  than whites (β black =0.10 [95% confidence interval, 0.05–0.15]; β white =0.18 [95% confidence interval, 0.14–0.22];  P =0.01). Having high relative  CVD  risk at an earlier age significantly reduced  CRM  (β age×slope =−0.02; 95% confidence interval, −0.03 to −0.01;  P <0.001). Relative  CRM  was strongly correlated with life course changes in Ideal Cardiovascular Health sum ( r =0.62; 95% confidence interval, 0.60–0.65).    Conclusions  Results from this novel application of an economic mobility index to cardiovascular epidemiology indicated substantial CRM, supporting the paradigm that life course  CVD  risk is highly modifiable. High  CRM  implies that the children with the best relative  CVD  profiles may only maintain a slim advantage over their peers into adulthood.

Cardiovascular Risk and the American Dream: Life Course Observations From the BHS (Bogalusa Heart Study)