Abstract P559: National Burden & Cardiovascular Risk Factor Profile of Stroke Among Young Adults in The United States

Introduction: Stroke is a leading cause of death and disability worldwide. While most prevalent in elderly, it’s not uncommon in the non-elderly (<65), who also experience many more years of living with disability. In this study, we aimed to describe the scope and CVD determinants of stroke among young (18-44 years) adults in a US representative population. Methods: We analyzed the National Health Interview Survey (2012-2018), a nationally representative study sample. Stroke, as well as CVD risk factors (CRF) [diabetes, hypertension, ever-smoker, insufficient physical activity, obesity and high cholesterol] were self-reported. A CRF profile was then created, with the following categories: “Optimal”, “Average” and “Poor” (0-1, 2-3 & ≥ 4 CRFs, respectively). All analyses took into consideration the survey’s complex design. Results: The 2012-2018 survey population consisted of 224,638 adults ≥ 18 yrs, ≈ 242 million US adults annually. Overall 2.8% (≈ 7 million) reported ever having history of stroke, with 45% noted in the non-elderly (< 65). Among non-elderly, 21% of stroke-history was allocated among the young (18-44 years) adults, translating to nearly 642,810 individuals reporting ever having history of stroke per year. The most common risk factors noted in these patients were insufficient physical activity (56%), current/past smoking (48%), obesity (45%), and hypertension (44%). Overall among the young (<45 years), stroke prevalence was 10-fold higher among those with poor (≈ 3.9 million young adults) vs optimal CRF profile (3.5% vs 0.3%, p < 0.001). Adjusting for demographics, all CVD risk were significantly associated with history of stroke, with participants with poor CRF reporting a 7-fold higher history of stroke (Table). Conclusion: More than half a million adults 18-44 years of age reported a history stroke in US. Individuals with sub-optimal CRF profiles are highly susceptible, and population-level strategies emphasizing cardiovascular health may significantly reduce risk of stroke among young adults in US.

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Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

Journal of the American Heart Association ◽

10.1161/jaha.121.022837 ◽

2022 ◽

Author(s):

Garima Sharma ◽

Gowtham R. Grandhi ◽

Isaac Acquah ◽

Reed Mszar ◽

Shiwani Mahajan ◽

...

Keyword(s):

Physical Activity ◽

United States ◽

Risk Factors ◽

Pregnant Women ◽

Social Determinants ◽

Cardiovascular Health ◽

The United States ◽

Cross Sectional ◽

Food Education ◽

Insufficient Physical Activity

Background Suboptimal cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We aimed to evaluate the association of SDOH with suboptimal CVH among pregnant women in the United States. Methods and Results We examined cross‐sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013–2017). We ascertained optimal and suboptimal CVH based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes, hyperlipidemia, current smoking, obesity, and insufficient physical activity), respectively. We calculated an aggregate SDOH score representing 38 variables from 6 domains (economic stability; neighborhood, physical environment, and social cohesion; community and social context; food; education; and healthcare system) and divided into quartiles. We used Poisson regression model to evaluate the association of SDOH with suboptimal CVH and risk factors. Our study included 1433 pregnant women (28.8±5.5 years, 13% non‐Hispanic Black). Overall, 38.4% (95% CI, 33.9–43.0) had suboptimal CVH versus 51.7% (95% CI, 47.0–56.3) among those in the fourth SDOH quartile. Risk ratios of suboptimal CVH, smoking, obesity, and insufficient physical activity were 2.05 (95% CI, 1.46–2.88), 8.37 (95% CI, 3.00–23.43), 1.54 (95% CI, 1.17–2.03), and 1.19 (95% CI, 1.01–1.42), respectively among those in the fourth SDOH quartile compared with the first quartile. Conclusions Over 50% of pregnant women with the highest SDOH burden had suboptimal CVH, highlighting the public health urgency for interventions in socially disadvantaged pregnant women with renewed strategies toward improving modifiable risk factors, especially smoking and insufficient physical activity.

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Abstract 17019: Obesity and Cardiovascular Health in Young American Adults

Circulation ◽

10.1161/circ.142.suppl_3.17019 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sarabjeet S Suri ◽

Vibhu Parcha ◽

Rajat Kalra ◽

Garima Arora ◽

Pankaj Arora

Keyword(s):

Risk Factors ◽

Young Adults ◽

Cardiovascular Health ◽

Piecewise Linear ◽

The United States ◽

Obesity Prevalence ◽

Logistic Regression Models ◽

Prevalence Of Obesity ◽

Adjusted Logistic Regression ◽

The Impact

Background: The growing epidemic of obesity in the United States (US) is associated with cardiovascular (CV) morbidity and mortality. We evaluated the impact of the increasing obesity prevalence on the CV health of young American adults. Methods: The age-adjusted weighted prevalence of hypertension, diabetes, and hypercholesterolemia was estimated from the 2008-2018 National Health and Nutrition Examination Survey (NHANES) in American adults aged 18-44 years, stratified by the presence of obesity. The trends were evaluated using a piecewise linear regression approach. The odds for CV risk factors were estimated using multivariable-adjusted logistic regression models. Results: Among 14,919 young adults, the prevalence of obesity was 33.9% (95% CI: 32.6-35.3%). Obese young adults were more likely to be non-Hispanic Blacks and in lower socioeconomic and educational attainment strata (p<0.05 for all). Obese young adults had a greater risk of having hypertension (adjusted odds ratio [aOR]: 3.0 [95% CI: 2.7-3.4]), diabetes (aOR: 4.3 [95% CI: 3.3-5.6]), and hyperlipidemia (aOR: 1.47 [95% CI: 1.3-1.7]). Among obese, hypertension increased from 36.5% (33.9-39.1%) in 2007-2010 to 39.4% (35.6-43.1%) in 2015-2018 (p= 0.07) and diabetes increased from 4.7% (3.6-5.8%) in 2007-2010 to 7.1% (5.3-9.0%) in 2015-2018 (p=0.11). A modest increase in diabetes was seen in non-obese individuals ( Table ). Hypercholesterolemia prevalence remained unchanged from 12.6% (95% CI: 10.6-14.7%) 2007-2010 to 10.9% (95% CI: 9.0-12.8%) in 2015-2018 (p=0.27) among obese young adults. Non-obese young adults showed a decline in hypercholesterolemia from 9.5% (95% CI: 8.0-11.0%) in 2007- 2010 to 7.1% (95% CI: 5.8-8.4%) in 2015-2018 (p=0.002). Conclusions: Nearly one-in-every three young American adults have obesity, which is accompanied by a two-fold higher prevalence of CV risk factors. The CV morbidity in young adults is expected to increase with an increasing prevalence of obesity..

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Physical activity, physical fitness, and cardiovascular health

10.1093/med/9780199232482.003.0025 ◽

2013 ◽

Author(s):

Jos Twisk ◽

Isabel Ferreira

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Physical Fitness ◽

Children And Adolescents ◽

Cardiovascular Health ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Apo B

The incidence of morbidity and mortality related to CVD is rather low in a paediatric population. Studies investigating the relationship between physical activity, physical fitness, and cardiovascular health in children and adolescents are therefore mostly limited to CVD risk factors as outcome measures. For this reason, this chapter will focus on the association of physical activity and physical fitness with CVD risk factors in children and adolescents. These risk factors can be divided into the so-called traditional CVD risk factors; that is, lipoproteins [total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (TG)], blood pressure, body fatness, and diabetes, and ‘new’ CVD risk factors; that is, other lipoproteins [lipoprotein(a) (Lp(a)), apolipoprotein (apo)B, and apoA-1], coagulation and inflammation markers [fibrinogen, C-reactive protein (CRP)], homocysteine, and heart rate variability.

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Using Cluster Analysis to Explore Associations between Cardiovascular Risk and Lifestyle Factors in a Workplace Wellness Program

Building Healthy Academic Communities Journal ◽

10.18061/bhac.v5i1.7933 ◽

2021 ◽

Vol 5 (1) ◽

pp. 30-41

Author(s):

Heather Carter-Templeton ◽

Gary Templeton ◽

Barbara Ann Graves ◽

Leslie G. Cole

Keyword(s):

Risk Factors ◽

Cluster Analysis ◽

Risk Factor ◽

Cardiovascular Health ◽

The United States ◽

Workplace Wellness ◽

Wellness Program ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Ideal Cardiovascular Health

Background: Cardiovascular disease (CVD) is the number one cause of death in the United States with risk factors including hypertension, hyperlipidemia, diabetes, obesity, smoking, physical inactivity, age, genetics, and unhealthy diets. A university-based workplace wellness program (WWP) consisting of an annual biometric screening assessment with targeted, individualized health coaching was implemented in an effort to reduce these risk factors while encouraging and nurturing ideal cardiovascular health.Objective: The purpose of this study was to examine and describe the prevalence of single and combined, or multiple, CVD risk factors within a workplace wellness dataset.Methods: Cluster analysis was used to determine CVD risk factors within biometric screening data (BMI, waist circumference, LDL, total cholesterol, HDL, triglycerides, blood glucose age, ethnicity, and gender) collected during WWP interventions.Results: The cluster analysis provided visualizations of the distributions of participants having specific CVD risk factors. Of the 8,802 participants, 1,967 (22.4%) had no CVD risk factor, 1,497 (17%) had a single risk factor, and 5,529 (60.5%) had two or more risk factors. The majority of sample members are described as having more than one CVD risk factor with 78% having multiple.Conclusion: Cluster analysis demonstrated utility and efficacy in categorizing participant data based on their CVD risk factors. A baseline analysis of data was captured and provided understanding and awareness into employee health and CVD risk. This process and analysis facilitated WWP planning to target and focus on education to promote ideal cardiovascular health.

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Cardiovascular injury induced by tobacco products: assessment of risk factors and biomarkers of harm. A Tobacco Centers of Regulatory Science compilation

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00591.2018 ◽

2019 ◽

Vol 316 (4) ◽

pp. H801-H827 ◽

Cited By ~ 11

Author(s):

Daniel J. Conklin ◽

Suzaynn Schick ◽

Michael J. Blaha ◽

Alex Carll ◽

Andrew DeFilippis ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Health ◽

Electronic Cigarettes ◽

Population Level ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cvd Risk ◽

Tobacco Products ◽

Major Cardiovascular Events ◽

Organ Specific

Although substantial evidence shows that smoking is positively and robustly associated with cardiovascular disease (CVD), the CVD risk associated with the use of new and emerging tobacco products, such as electronic cigarettes, hookah, and heat-not-burn products, remains unclear. This uncertainty stems from lack of knowledge on how the use of these products affects cardiovascular health. Cardiovascular injury associated with the use of new tobacco products could be evaluated by measuring changes in biomarkers of cardiovascular harm that are sensitive to the use of combustible cigarettes. Such cardiovascular injury could be indexed at several levels. Preclinical changes contributing to the pathogenesis of disease could be monitored by measuring changes in systemic inflammation and oxidative stress, organ-specific dysfunctions could be gauged by measuring endothelial function (flow-mediated dilation), platelet aggregation, and arterial stiffness, and organ-specific injury could be evaluated by measuring endothelial microparticles and platelet-leukocyte aggregates. Classical risk factors, such as blood pressure, circulating lipoproteins, and insulin resistance, provide robust estimates of risk, and subclinical disease progression could be followed by measuring coronary artery Ca2+ and carotid intima-media thickness. Given that several of these biomarkers are well-established predictors of major cardiovascular events, the association of these biomarkers with the use of new and emerging tobacco products could be indicative of both individual and population-level CVD risk associated with the use of these products. Differential effects of tobacco products (conventional vs. new and emerging products) on different indexes of cardiovascular injury could also provide insights into mechanisms by which they induce cardiovascular harm.

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Physical activity profile of the Iranian population: STEPS survey, 2016

BMC Public Health ◽

10.1186/s12889-019-7592-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Farnam Mohebi ◽

Bahram Mohajer ◽

Moein Yoosefi ◽

Ali Sheidaei ◽

Hossein Zokaei ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Urban Areas ◽

Vegetable Consumption ◽

Adult Population ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Life Years ◽

Insufficient Physical Activity ◽

History Of

Abstract Background Insufficient physical activity (IPA) is one of the leading causes of premature mortality through the increased burden of non-communicable diseases. From 1990 to 2017, the percentage of low physical activity attributable disability-adjusted life years (DALY) increased globally by 1.5 times and 2-fold in Iran, causing more than 1.2 million deaths worldwide and 18,000 deaths in Iran in 2017. Reports suggest that Iran, a developing middle-income country, suffers from a high level of IPA. Socioeconomic and cultural alterations along with the country’s developments expose the population to IPA risk. We aimed to describe IPA prevalence in Iran’s adult population, categorized by demographics, geographical region, and activity domains to assess the present pattern of physical inactivity and its domains in the country. Methods In 2016, in order to represent Iran’s adult population, adult participants (n: 30541) from 30 provinces were selected using systematic proportional to size cluster sampling. Physical activity (PA) was assessed via the Global Physical Activity Questionnaire, calculating the Metabolic Equivalent of Task (MET) value in minutes per week for work, recreation, and transport domains. Insufficient physical activity (IPA) was defined according to WHO’s recommendation (less than 600 METs per week). Adjusted odds ratios of IPA associates for sociodemographic, lifestyle related variables, and metabolic risk factors were reported. Results A high prevalence of IPA was seen in the total population (54.7%, 95%CI: 54.0–55.3) with a considerable difference between the two genders (males: 45.3% (95%CI: 44.3–46.3); females: 61.9% (95%CI: 61.0–62.7)). Work-related activity was the domain with the greatest percentage of total PA, whereas, both genders lacked recreational activities. In our findings, being female, a housekeeper, younger and living in urban areas were significantly associated with higher levels of IPA. Moreover, insufficient fruit and vegetable consumption, lack of alcohol consumption, having a personal vehicle, and finally, having a medical history of diabetes were significantly associated with the presence of IPA in our population. Among the study population, 33.6% (95%CI: 33.0–34.2) had at least 4 h of sedentary behavior in a typical day. Conclusions Widespread IPA among the Iranian adult population is of major concern. In our findings, we observed a considerable gap in the prevalence and pattern of IPA between the two genders. Additionally, IPA was associated with living in urban areas, unhealthy lifestyle habits and a history of other metabolic risk factors. Thus, a prompt initiative for population-specific actions should be taken.

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Abstract 09: The Health Freedom Path to Wellness Program: A Novel Educational and Behavioral Intervention to Promote Cardiovascular Health Equity

Circulation ◽

10.1161/circ.141.suppl_1.09 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Tanjala S Purnell ◽

Ina Glenn-Smith ◽

Sunjae Bae ◽

Grecia Vargas ◽

Anika L Hines ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Blood Pressure ◽

Behavioral Intervention ◽

Cardiovascular Health ◽

Health Workers ◽

Opportunity To Learn ◽

Wellness Program ◽

Cvd Risk ◽

Associated Risk Factors

Background: African Americans (AAs) and adults living in urban communities continue to experience disproportionately high rates of cardiovascular disease (CVD) and associated risk factors (e.g., hypertension, diabetes, obesity) despite decades of recognition of these disparities. Methods: The Health Freedom Path to Wellness Program is an innovative community-based educational and behavioral intervention to reduce disparities in CVD risk factors. The goal of this study was to test the effectiveness of the Circle of Friends (COF) educational and social support component of the Health Freedom intervention. The Health Freedom-COF incorporated six weekly one-hour long sessions led by lay health workers trained in CVD health education based on the AHA’s Simple 7 guidelines, blood pressure (BP) measurement, physical activity, and behavior change strategies, and culminated in a 5K celebration walk that gives participants an opportunity to learn about Maryland’s important role in the Underground Railroad. Results: Study participants included 353 adults in Maryland (93% AAs, mean age: 53 years; 85% female; and 35% with annual incomes <$50,000). At baseline, mean BP(SD) was 127.4 (17.6)/77.1 (10.8) mmHg; mean weight in pounds (SD) was 191.6 (45.2); 43.1% had diagnosed hypertension, and 15.0% had diabetes. Compared with their pre-intervention assessments, adults who completed the intervention experienced an average reduction of -5.2 mm Hg systolic blood pressure (95% CI: 4.1-6.3, p<0.001) and -3.3 mm Hg diastolic BP (95% CI: 2.5-4.1, p<0.001). At baseline, only 3.3% of participants reported a weekly consumption of 5+ fruit servings; 5.9% reported 5+ vegetable servings, and 12.8% reported 5+ days of physical activity. However, after completing the program, 22.4% of participants reported a weekly consumption of 5+ fruit servings; 28.6% reported 5+ vegetable servings, and 46.7% reported 5+ days of physical activity. Conclusions: The Health Freedom educational and behavioral intervention was associated with improvements in blood pressure, diet, and physical activity among socially at-risk adults.

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Association of the combined effects of air pollution and changes in physical activity with cardiovascular disease in young adults

European Heart Journal ◽

10.1093/eurheartj/ehab139 ◽

2021 ◽

Author(s):

Seong Rae Kim ◽

Seulggie Choi ◽

Kyuwoong Kim ◽

Jooyoung Chang ◽

Sung Min Kim ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Air Pollution ◽

Young Adults ◽

Cardiovascular Health ◽

Combined Effects ◽

Cvd Risk ◽

Increased Risk ◽

High Pollution ◽

Pollution Exposure

Abstract Aims Little is known about the trade-off between the health benefits of physical activity (PA) and the potential harmful effects of increased exposure to air pollution during outdoor PA. We examined the association of the combined effects of air pollution and changes in PA with cardiovascular disease (CVD) in young adults. Methods and results This nationwide cohort study included 1 469 972 young adults aged 20–39 years. Air pollution exposure was estimated by the annual average cumulative level of particulate matter (PM). PA was calculated as minutes of metabolic equivalent tasks per week (MET-min/week) based on two consecutive health examinations from 2009 to 2012. Compared with the participants exposed to low-to-moderate levels of PM2.5 or PM10 who continuously engaged in ≥1000 MET-min/week of PA, those who decreased their PA from ≥1000 MET-min/week to 1–499 MET-min/week [PM10 adjusted hazard ratio (aHR) 1.22; 95% confidence interval (CI) 1.00–1.48] and to 0 MET-min/week (physically inactive; PM10 aHR 1.38; 95% CI 1.07–1.78) had an increased risk of CVD (P for trend <0.01). Among participants exposed to high levels of PM2.5 or PM10, the risk of CVD was elevated with an increase in PA above 1000 MET-min/week. Conclusion Reducing PA may lead to subsequent elevation of CVD risk in young adults exposed to low-to-moderate levels of PM2.5 or PM10, whereas a large increase in PA in a high-pollution environment may adversely affect cardiovascular health.

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Physical activity and cardiovascular disease risk in women with polycystic ovary syndrome

10.7190/shu-thesis-00398 ◽

2021 ◽

Author(s):

◽

Amie Woodward

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiovascular Health ◽

Exercise Intervention ◽

Polycystic Ovary ◽

Exercise Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Exercise Interventions ◽

Supervised Exercise

Background Polycystic ovary syndrome (PCOS) is a complex, heterogeneous endocrinopathy affecting metabolic, reproductive, and cardiovascular health in women. Evidence indicates that women with PCOS present with a cluster of cardiovascular disease (CVD) risk factors. Physical activity (PA) interventions have been shown to reduce various CVD risk factors in women with PCOS. Research also suggests that sedentary behaviours have a distinct deleterious effect on cardiometabolic health. Thus, increasing PA and reducing sedentary behaviour may be a worthwhile therapeutic target to improve cardiovascular health in women with PCOS. The programme of research presented in this thesis investigates the feasibility and acceptability of two PA interventions to improve markers of CVD risk in women with PCOS using both quantitative and qualitive methods. Methods A systematic review and meta-analysis of the effects of exercise interventions on CVD risk factors in women with PCOS provided an evidence base on which to design a supervised exercise intervention. A feasibility randomised controlled trial (RCT) of two physical activity interventions for women with PCOS was conducted. Participants were randomised to either a supervised exercise intervention, a lifestyle physical activity intervention (LPAG) aimed at reducing sedentary behaviours, or a control group, for 12 weeks. Semi-structured interviews were conducted with a purposive sample of participants from each group on completion of the RCT to explore the acceptability of the interventions, and barriers and facilitators to PA. Results The systematic review and meta-analysis demonstrated that moderate intensity aerobic exercise interventions of ≥three months in duration, with a frequency of three sessions/week, had favourable effects on CVD risk factors. These results informed the design of the RCT. Thirty-six women with PCOS were enrolled onto the feasibility RCT (12 per group). The recruitment rate was 56% and adherence rate to the exercise intervention was considered moderate at 53%. The retention rate was high at 89%, with only five participants lost to follow-up. Adherence to the LPAG was 100%. Two non-serious adverse events were reported in the exercise group, unrelated to trial procedures. For the secondary outcomes, trend data indicates a 14% reduction in oxidised LDL concentrations in the exercise group. In addition, the data indicates weight loss (kg) of 3.4% and 3.6% in the exercise group and the LPAG, respectively. Qualitative data from the interviews (n=11) indicated that the interventions were well received, but acceptability could be improved by providing social connectivity and implementing measures that encourage the adoption of long-term health-promoting behaviours. Conclusions iii The findings suggest that the procedures for recruitment, allocation, and outcome measurements were acceptable. However, adherence to the supervised exercise intervention was below an acceptable rate. The qualitative component provides valuable contextual data that will be crucial to addressing adherence for both the progression to a full-scale RCT, and community interventions for women with PCOS.

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Abstract P013: Prevalence, Correlates and Prognosis of Healthy Vascular Aging in a Western Community-dwelling Population

Circulation ◽

10.1161/circ.135.suppl_1.p013 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Teemu Niiranen ◽

Asya Lyass ◽

Martin Larson ◽

Naomi Hamburg ◽

Emelia Benjamin ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Regression Models ◽

Cardiovascular Health ◽

Vascular Aging ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Health Score ◽

Unit Increase ◽

Life’S Simple 7

Introduction: Although hypertension in the elderly is no longer considered harmless, increasing arterial stiffness and blood pressure (BP) are still widely seen as inevitable parts of the aging process. However, these phenomena may not be unavoidable as they are nearly absent in populations leading traditional hunter-gatherer lifestyles. Our study had 3 aims: 1) to define a new concept - healthy vascular aging (HVA); 2) to assess prevalence and correlates of HVA in a sample acculturated to a western life-style; and 3) to estimate the magnitude of cardiovascular (CVD) risk associated with HVA vs. absence of HVA. Methods: We studied 3197 Framingham Heart Study participants aged ≥50 years (62±9 years, 56% women) who underwent physical examination, interviews, and measurement of carotid-femoral pulse wave velocity (PWV) in 1999-2008. We defined HVA as no hypertension (BP <140/90 mmHg without antihypertensive treatment) and PWV <7.6 m/s (equivalent to +2 SD above mean of non-hypertensive reference sample aged <30 years with no CVD risk factors). We used logistic regression models that included physical activity, caloric intake, and classical CVD factors as covariates to assess the correlates of HVA. For each participant, we constructed a cardiovascular health score based on presence vs. absence of 6 modifiable risk factors (cholesterol, plasma glucose, healthy diet score, physical activity, body mass index (BMI), and smoking) defined as dichotomous variables according to the American Heart Association’s Life’s Simple 7 score (modified to exclude hypertension). We estimated odds ratios (OR) per 1-unit increase in cardiovascular health score for HVA. We used Cox regression models adjusted for classical CVD risk factors, including systolic BP, to assess the relationship between HVA and incident CVD events (CVD death, myocardial infarction, heart failure, stroke, and unstable angina). Results: In our sample, only 566 (17.7%) had HVA. Lower age (OR per 1-SD increase 0.18, 95% confidence interval [CI] 0.14-0.23), female sex (OR 2.03; 95% CI 1.54-2.68), lower BMI (OR per 1-SD increase 0.54; 95% CI 0.47-0.63) and no diabetes (OR 0.09; 95% CI 0.02-0.36) were significantly associated with HVA. A 1-unit increase in the cardiovascular health score conferred 1.55-fold (95% CI 1.38-1.74) odds of HVA. During follow-up (median 9.6 years), 391 participants had CVD events. HVA was associated with an age- and sex-adjusted hazard ratio (HR) of 0.36 (95% CI, 0.22-0.60) and a multivariable-adjusted HR of 0.45 (95% CI, 0.26-0.77) for CVD relative to absence of HVA. Conclusions: One in 6 individuals experiences HVA in our sample. Individuals with HVA are at a considerably low risk of CVD. Prevention strategies targeting modifiable factors and behaviors included in Life’s Simple 7 are important for preventing or delaying vascular aging and the associated risk of CVD.

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