The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study

Introduction: With the development of new health metrics to define ideal cardiovascular health (CVH), several studies have examined the distribution of the American Heart Association (AHA) 2020 ideal CVH metrics both within and outside the United States (US). In this meta-analysis of proportions, we synthesized available data on ideal CVH metrics distribution in US cohorts and compared them with non-US populations. Methods: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “ideal cardiovascular health” between January 2000 and October 2014. Studies were included in the meta-analysis if the proportions achieving ideal for 0, 1, 2, 3, 4, 5 or ≥6 ideal CVH metrics were known or could be estimated. A meta-analysis of proportions was conducted for US and non-US studies using a random effect model (REM). REM models were chosen because of the significant heterogeneity among studies. Results: Overall the pooled data consisted of 10 US cohorts with a total population of 94,761 participants and 6 non-US cohorts with a total of 130,242 participants. The table shows the pooled prevalence of ideal CVH factors in this population. Overall the pooled estimates of US cohorts showed 15% had 0-1 ideal CVH metrics (inter-study range: 7-22%), while 3% (inter-study range: 1-10%) had 6-7 ideal CVH metrics. This is comparable to 12% (inter-study range 1-17%) and 2% (inter-study range: 1-12%) for 0-1 and 6-7 ideal CVH metrics in the non-US studies. Conclusion: The proportion of persons achieving 6 or more ideal CVH metrics in both US and non-US cohorts is very low and the distribution of CVH metrics is similar in both US and non-US populations. Considering the strong association with worse outcomes, a coordinated global effort at improving CVH should be considered a priority.

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Abstract P015: A Novel Healthy Blood Pressure Phenotype is Associated With Better Cardiovascular Health Benefits and Neuropsychological Performance in the Long Life Family Study

Circulation ◽

10.1161/circ.135.suppl_1.p015 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Megan M Marron ◽

Robert M Boudreau ◽

Kaare Christensen ◽

Stephanie Cosentino ◽

Mary Feitosa ◽

...

Keyword(s):

Blood Pressure ◽

Neuropsychological Tests ◽

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Family Study ◽

Heart Association ◽

Ideal Cardiovascular Health ◽

Blood Pressure Phenotype ◽

The U.S

Introduction: We assessed the hypothesis that a novel healthy blood pressure phenotype is familial and sought to identify factors associated with this phenotype in the Long Life Family Study (LLFS). Methods: The LLFS is a unique multi-center, international study that recruited families demonstrating clustering for longevity. Families were recruited from four centers; three in the U.S.: Boston, New York, and Pittsburgh and one in Denmark. The pedigrees included two generations: 1) probands and their siblings and 2) offspring of participants in the proband generation. Offspring (n=2211, ages 32-88, mean age=60.5; 43% male) were classified as having healthy blood pressure if their age- and sex-adjusted systolic blood pressure z-score was between -1.5 and -0.5 (i.e., a systolic blood pressure lower than expected for their age and sex, but not “too low”). Offspring on anti-hypertensive medications were classified as not having healthy blood pressure. Families (n=419) were defined as having healthy blood pressure if ≥2 and ≥50% of their offspring met the healthy blood pressure phenotype. Results: There were 476 (22%) offspring who met the healthy blood pressure phenotype. These offspring tended to have a better health profile than remaining offspring. When examining families, only 44 (11%) families met the criteria for healthy blood pressure. Both offspring and probands from families with healthy blood pressure performed better on neuropsychological tests that place demands on complex attention and executive function than offspring and probands from remaining families. Among families with healthy blood pressure, a higher proportion of offspring met the American Heart Association ideal cardiovascular health definition compared to remaining families (11% versus 4%, respectively, p<0.0001; not including the diet component). There was also a larger proportion of probands (n=1164, ages 71-110, mean age=90.5; 45% male) who met the American Heart Association ideal cardiovascular health definition when compared to the U.S. prevalence for ≥6 components among those ages ≥60 (1% versus 0.1%, respectively). Conclusion: In this cohort of familial longevity, few families had a novel healthy blood pressure phenotype in multiple members. Families and individuals with healthy blood pressure performed better on neuropsychological tests that represent aspects of executive function and had a higher proportion with ideal cardiovascular health than the U.S. population. In summary, a novel healthy blood pressure phenotype was rarely familial in this cohort; however, when it was, it was associated with cognitive and cardiovascular health benefits. Blood pressure may be a key pathway for family longevity.

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American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22–35-year-old adults conceived with and without assisted reproductive technologies

Human Reproduction ◽

10.1093/humrep/dez240 ◽

2019 ◽

Vol 35 (1) ◽

pp. 232-239 ◽

Cited By ~ 2

Author(s):

Markus Juonala ◽

Sharon Lewis ◽

Robert McLachlan ◽

Karin Hammarberg ◽

Joanne Kennedy ◽

...

Keyword(s):

Cardiovascular Risk ◽

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Subclinical Atherosclerosis ◽

Heart Association ◽

Categorical Variables ◽

Inverse Association ◽

Health Score ◽

Ideal Cardiovascular Health

Abstract STUDY QUESTION Is ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis? SUMMARY ANSWER The associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude. WHAT IS KNOWN ALREADY Long-term consequences of ART on cardiovascular health are unknown. STUDY DESIGN, SIZE, DURATION The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22–35 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always >0.2). AHA score was not associated with cIMT or retinal measures in either group (P always >0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) −0.18(−0.26 to −0.10)). A numerically similar relationship was observed in the smaller non-ART group (−0.19(−0.39 to 0.01)). LIMITATIONS, REASONS FOR CAUTION Even though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children’s Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.

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Socioeconomic position and intergenerational associations of ideal health behaviors

European Journal of Preventive Cardiology ◽

10.1177/2047487319850959 ◽

2019 ◽

Vol 26 (15) ◽

pp. 1605-1612 ◽

Cited By ~ 2

Author(s):

Kaisla Komulainen ◽

Murray A Mittleman ◽

Markus Jokela ◽

Tomi T Laitinen ◽

Katja Pahkala ◽

...

Keyword(s):

Health Behaviors ◽

Socioeconomic Position ◽

American Heart Association ◽

Parental Education ◽

Cardiovascular Health ◽

American Heart ◽

Heart Association ◽

Repeated Measurements ◽

Adult Offspring ◽

Ideal Cardiovascular Health

Background Promoting ideal cardiovascular health behaviors is an objective of the American Heart Association 2020 goals. We hypothesized that ideal health behaviors of parents are associated with health behaviors of their adult offspring, and that higher socioeconomic position in either generation enhances intergenerational associations of ideal health behaviors. Design Prospective cohort study. Methods We included 1856 Young Finns Study participants who had repeated measurements of socioeconomic position (education, income, occupation), smoking status, body mass index, physical activity and diet from 2001, 2007 and 2011, and data on parental socioeconomic position and health behaviors from 1980. We calculated the total number of ideal behaviors in both generations using American Heart Association definitions. Intergenerational associations were examined using ordinal and linear multilevel regression with random intercepts, in which each participant contributed one, two or three measurements of adult health behaviors (2001, 2007, 2011). All analyses were adjusted for offspring sex, birth year, age, parental education and single parenthood. Results Overall, parental ideal health behaviors were associated with ideal behaviors among offspring (odds ratio (OR) 1.28, 95% confidence interval 1.17, 1.39). Furthermore, ORs for these intergenerational associations were greater among offspring whose parents or who themselves had higher educational attainment (OR 1.56 for high vs. OR 1.19 for low parental education; P = 0.01 for interaction, OR 1.32 for high vs. OR 1.04 for low offspring education; P = 0.02 for interaction). Similar trends were seen with parental income and offspring occupation. Results from linear regression analyses were similar. Conclusions These prospective data suggest higher socioeconomic position in parents or in their adult offspring strengthens the intergenerational continuum of ideal cardiovascular health behaviors.

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Correction to: Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America

Circulation ◽

10.1161/cir.0000000000000735 ◽

2019 ◽

Vol 140 (12) ◽

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

American Heart Association ◽

American Heart ◽

Heart Association ◽

Scientific Statement

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Abstract P003: Comparison of Ideal Cardiovascular Health Status Across National Representative Cohorts: A Systematic Review

Circulation ◽

10.1161/circ.133.suppl_1.p003 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Adnan Younus ◽

Rehan Malik ◽

Rameez Ahmad ◽

Shozab Ali ◽

Muhammad Aziz ◽

...

Keyword(s):

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Heart Association ◽

Free Text ◽

Ideal Cardiovascular Health ◽

Pooled Data ◽

Sustainable Improvement ◽

Majority Population ◽

Cross National

Introduction: In 2010, the American Heart Association set 2020 national goals for promoting cardiovascular health (CVH), emphasizing measurement of reproducible health behaviors and health factors and attaining ideal CVH status. In recent years, significant emphasis has been placed on adopting these metrics globally to monitor strategies to improve CVH. In this study, we synthesize available data to compare distribution of CVH metric metrics detailed in national representative cohorts a focus on presence of ideal CVH (ICVH). Method: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “Ideal cardiovascular health”. Ideal CVH was defined as 6-7 ideal factors; conversely poor ICVH was considered as 0-1 ideal factors. Results: The pooled data comprised of 7 cross-national cohorts with a total of 152289 participants from India, United States, China, Spain, Korea, Luxembourg and Republic of Srpska. Significant variations in individual ideal CVH metrics were noted. Across population cohorts, diet metric consistently appeared suboptimal apart from Korea in which 55% participants reported ideal diet status. Overall majority population in each of the 7 cross-national cohorts lied in the range having 2-5 ideal CV health metrics (79-88%). A very small percentage of each population had 0-1 METRICS, with Spain, USA and Republic of Srpska having the highest percentage (18%) of reported poor ICVH. On the other hand, only representative cohorts from China and Korea reported ideal CVH status in more than 10% population. Conclusion: Overall suboptimal proportion of national representative cohorts have reported ideal CVH status. Significant efforts are needed to streamline current policies for enhancing CVH and sharpening focus interventions that will yield the greatest sustainable improvement in population CVH status.

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