Cardiovascular disease is one of the largest killers in the UK representing 30% of all global deaths. The underlying processes of the disease are thought to begin in childhood. Whilst traditional risk factors of CV disease (e. g. hypertension, hyperlipidemia, obesity, smoking, stress and sedentary lifestyles) are becoming increasingly prevalent within the younger generation there remains the need for the establishment of earlier or "pre-clinical" markers of future CV disease risk or current

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... rosclerotic load such as left ventricular (LV) mass, diastolic function and carotid intima-media thickness (cIMT). Further, assessing the association of these markers to other risk factors and then determining the impact physical activity (PA) interventions is warranted. Initially we assessed the impact of body composition, PA and cardiorespiratory (CR) fitness upon left ventricular LV mass, carotid-intima media thickness (cIMT) and LV diastolic function in 218 9-11 year old primary schoolchildren. Pubertal status was assessed through a maturity offset calculation. LV mass, cIMT, and LV diastolic function were assessedvia ultrasound. Body mass index was assessed via anthropometry whilst fat mass [FM] and lean mass [LM] were determined via dual Xray absorptiometry. Average 3-day PA was recorded via a uni-axial accelerometer and CR (VO2peak) was determined from a graded treadmill test. Relationships were analysed using bivariate correlations and forced entry multiple regression. All children were classified as being below their peak height velocity. Together LM, FM, sex and moderate to vigorous (MV)PA accounted for 59% of the variance in LV mass with LM being the most important predictor (P<0.005). Sex, LM, FM and VO2peak explained only 19% variance in cIMT and just 9% of the variance in LV diastolic function was accounted for by LM, FM blood pressure and sex. Data for MVPA had no significant relationship to any cardiovascular (CV) variables although was negatively correlated with FM. The strong association between LV mass and body composition likely represents normal growth. The limited shared variance between predictor variables and cIMT and LV diastolic function suggests that those pre-peak height velocity children in the current cohort who were overweight, inactive and unfit were not yet at an increased CV disease risk. Thus there is a window of opportunity for intervention programmes to be implemented that reduce CV disease risk before adolescence and adulthood.