Ideal cardiovascular health and incidence of cardiovascular disease: Heterogeneity across event phenotype and contribution of multiple biomarkers. The prime study

2017 ◽  
Vol 263 ◽  
pp. e189-e190 ◽  
Author(s):  
Bamba Gaye ◽  
Muriel Tafflet ◽  
Dominique Arveil ◽  
Michèle Montaye ◽  
Frank Kee ◽  
...  
2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Bamba Gaye ◽  
Muriel Tafflet ◽  
Dominique Arveil ◽  
Frank Kee ◽  
Alun Evans ◽  
...  

Aims: To investigate whether or not the association between baseline cardiovascular health (CVH) and incident cardiovascular disease (CVD) differs by event phenotypes and to address the mediating effect of inflammatory and haemostatic blood biomarkers. Methods: The association of ideal CVH with outcomes was computed in 9312 middle-aged men from Northern Ireland and France (whole cohort) in multivariable Cox proportional hazards regression analysis. The mediating effect of baseline blood biomarkers was evaluated in a case control study nested within the cohort after 10 years of follow-up. Results: After a median follow-up of 10 years, 614 first CHD events and 117 first stroke events were adjudicated. Compared to those with poor CVH, those with an ideal CVH profile at baseline had a 72% lower risk of CHD (HR=0.28; 95% CI: 0.17; 0.46) and a 76% lower risk of stroke (HR=0.24; 95% CI: 0.06; 0.98). No heterogeneity was detected across main CHD and main stroke phenotypes. While significantly lower mean concentrations of hs-CRP, IL-6 (inflammatory markers), and fibrinogen, von Willbrandt factor (haemostatic factors) were noted in the controls with higher CVH status, the association of CVH with incident CHD was not attenuated upon adjustment for these biomarkers. Conclusion: these results support the universal promotion of ideal CVH for CVD in general and suggest that the lower risk of CHD associated with ideal CVH is independent from inflammatory and haemostatic biomarkers.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mei Zhang ◽  
Yu Shi ◽  
Oumin Shi ◽  
Zhenping Zhao ◽  
Xiao Zhang ◽  
...  

Background: Cardiovascular disease is the leading cause of death in China. Objectives: We aimed to evaluate the levels of cardiovascular health among Chinese adults and to understand the geographic patterns based on a nationally and provincially representative survey. Methods: In 2015, a total of 74,771 respondents aged ≥ 20 years with no history of cardiovascular disease were randomly sampled from 298 counties/districts of 31 provinces in mainland China and were interviewed. Seven metrics, including smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting glucose, were determined. Ideal cardiovascular health was defined as the simultaneous presence of all metrics at the ideal level. A score ranging from 0 to 14 was calculated as the sum of all seven metrics for each province. Scores for four health behaviors and four health factors were also calculated. Results: The age-adjusted prevalence of ideal cardiovascular health was only 1.13% among Chinese adults above 20 years old in 2015 (0.50% among men and 1.77% among women; 1.63% among urban residents and 0.68% among rural residents). The age-adjusted prevalence varied greatly across provinces, ranging from 0.05% in Qinghai to 2.97% in Heilongjiang. Ideal diet (7.4%) was the least common among seven cardiovascular health metrics and ideal blood pressure (32.2%) was the second least one. We also saw significant heterogeneity among provinces in age-adjusted cardiovascular health score, health behavior score, and health factors score. In all provinces, women had higher scores than men for cardiovascular health, health behaviors and health factors. Differences in cardiovascular health and health behavior scores between urban and rural areas were associated with levels of socio-economic development. Conclusions: Strategies for addressing poor cardiovascular health require geographic targeting and localized consideration.


2018 ◽  
Vol 41 (12) ◽  
pp. 1593-1599 ◽  
Author(s):  
Daniel Shpilsky ◽  
Claudia Bambs ◽  
Kevin Kip ◽  
Sanjay Patel ◽  
Aryan Aiyer ◽  
...  

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Joshua D Bundy ◽  
Hongyan Ning ◽  
Amanda E Paluch ◽  
Victor W Zhong ◽  
Donald M Lloyd-Jones ◽  
...  

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Luc Djousse ◽  
Andrew Petrone ◽  
Chad Blackshear ◽  
Michael Griswold ◽  
Jane Harman ◽  
...  

Background: While the prevalence of cardiovascular health metrics or Life’s Simple Seven (LSS) has been shown to be far from optimal in the US, such information has been predominantly reported in Caucasians. The burden of cardiovascular disease among African Americans underscores the need to evaluate the prevalence and secular trends of LSS in other ethnic groups. Objective: To test the hypothesis that the prevalence of the LSS is far from ideal among participants of the Jackson Heart Study. Methods: We analyzed LSS with 3,500 African Americans from the Jackson Heart Study, using data from their first clinic visit (2000-2004). Standard methods were used to measure blood pressure, glucose, body mass index (BMI), and cholesterol. Information on physical activity, smoking, and diet was collected with interviewer-administered questionnaires. Each of the LSS metrics (smoking status, diet, physical activity, BMI, fasting blood glucose, total cholesterol, and blood pressure) was categorized as poor, intermediate, or ideal, as defined by the AHA guidelines. Results: The mean age at baseline was 56.9 ± 12.2 years and 2,350 participants (67%) were women. Among men, the prevalence of having 0, 1, 2, 3, 4, 5, 6, and 7 ideal cardiovascular health metrics was 6.6%, 25.8%, 32.7%, 21.6%, 10.6%, 2.3%, 0.4%, and 0%, respectively. Corresponding values for women were 3.2%, 28.1%, 32.9%, 22.3%, 10.1%, 2.9%, 0.38%, and 0%. While about two-thirds of men and women reported ideal smoking status, almost none reported ideal diet quality, and few met recommendations for BMI and blood pressure ( Figure) . Conclusions: Our data are consistent with less than optimal prevalence of cardiovascular health metrics in both men and women from the Jackson Heart Study. The lower prevalence of meeting ideal recommendations for diet, physical activity, BMI, and blood pressure underscores the need for targeted interventions to improve these modifiable lifestyle factors in order to reduce the burden of cardiovascular disease among African-Americans.


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