📖 ABSTRACT/OVERVIEW
Background: Life-course epidemiology offers a theoretical framework for understanding how early-life social exposures accumulate to shape adult cardiovascular disease risk. Its application to the South South geopolitical zone of Nigeria provides original evidence on socially patterned cardiovascular risk pathways in a West African population. This study applies a life-course perspective to examine social determinants of cardiovascular disease risk accumulation among adults in Cross River State. Methodology: A retrospective life-history study enrolled 360 adults with and without established cardiovascular risk factors using a purposive life-course sampling framework. Structured life-history interviews captured socioeconomic exposures across childhood, adolescence, and adulthood. Latent class analysis identified risk accumulation trajectories, and multinomial logistic regression linked trajectory membership to adult cardiovascular outcomes. Results: Four life-course trajectories were identified: sustained advantage, upward mobility, sustained disadvantage, and downward mobility. Sustained disadvantage trajectory was associated with the highest cardiovascular risk factor burden. Critical period exposures in early childhood including food insecurity and maternal health deprivation had effects independent of adult socioeconomic status. Conclusion: Cardiovascular risk in Cross River State is socially accumulated across the life course with critical period vulnerabilities in early childhood. Family medicine preventive programmes must adopt longitudinal community health approaches that intervene across the life course rather than focusing exclusively on adult risk factor modification. Keywords: life-course, social determinants, cardiovascular disease, Cross River State, risk accumulation
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