Effects of Adolescent Parenting Styles on Adult Cardiovascular Conditions: A Population-Based Cohort Study

Purpose: Family-based interventions are proposed for primordial cardiovascular disease (CVD) prevention, yet which family-environment components to target remains unclear. We quantified effects of parenting styles in adolescence on adult cardiovascular conditions, including hypertension, and whether effects differ by family financial hardship. Methods: Data were from the US National Longitudinal Study of Adolescent to Adult Health (n=4,050). Parenting styles were derived via latent class analysis of adolescent-reported parental responsiveness and demandingness (ages 12-19, 1994-1995). Family financial hardship was based on parent-reported ability to pay bills. CVD and hypertension were assessed via biomarkers and self-report (ages 33-43, 2016-2018). Confounding factors were selected based on a directed acyclic graph; risk differences were estimated using doubly robust inverse-probability-weighted models. Results: Three parenting styles emerged: authoritative (11.1%), permissive (77.9%), and indifferent (11.0%). After 21 years, 33.0% had CVD or hypertension. Whole-population risk differences for permissive and indifferent versus authoritative parenting were -1.0% (95% CI: -5.3, 3.3%) and -1.8% (95% CI: -7.8, 4.2%), respectively. Among families reporting financial hardship, permissive parenting had lower risk (-15.9%, 95%CI: -28.4%, -3.3%), though inconsistent across sensitivity analyses. Conclusions: Adolescent parenting styles had small estimated long-term cardiovascular effects, with no robust evidence of differences by financial hardship.