Ideal cardiovascular health at age 5–6 years and cardiometabolic outcomes in preadolescence

Abstract Background The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5–6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11–12. Methods A total of 1666 children aged 5–6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. Results At age 5–6 years, 11% scored poor (score 1–5), 56% intermediate (score 6–7) and 33% good (score 8–9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11–12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend < 0.001), lower systolic (p for trend = 0.012) and diastolic blood pressure (p for trend = 0.011), and lower body mass index (BMI) (p < 0.001) at age 11–12. The original ICH score was associated with lower total cholesterol (p < 0.001) and BMI (p < 0.001) only. Conclusion Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.

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Ideal cardiovascular health at age 5-6 years and cardiometabolic outcomes in preadolescence

10.21203/rs.3.rs-67772/v2 ◽

2020 ◽

Author(s):

Hester Jaspers Faijer - Westerink ◽

Mette Stavnsbo ◽

Barbara A. Hutten ◽

Mai Chinapaw ◽

Tanja GM Vrijkotte

Keyword(s):

Blood Pressure ◽

Total Cholesterol ◽

Weight Status ◽

Cardiovascular Health ◽

Health Behaviours ◽

Healthy Weight ◽

Ideal Cardiovascular Health ◽

Health Factors ◽

Lower Total Cholesterol ◽

Ich Score

Abstract Background- The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12.Methods- A total of 1,666 children aged 5-6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models.Results- At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend <0.001), lower systolic (p for trend=0.012) and diastolic blood pressure (p for trend=0.011), and lower body mass index (BMI) (p<0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p<0.001) and BMI (p<0.001) only.Conclusion- Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.

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Ideal Cardiovascular Health at Age 5-6 years and Cardiometabolic Outcomes in Preadolescence

10.21203/rs.3.rs-67772/v1 ◽

2020 ◽

Author(s):

Hester Jaspers Faijer - Westerink ◽

Mette Stavnsbo ◽

Barbara A. Hutten ◽

Mai Chinapaw ◽

Tanja GM Vrijkotte

Keyword(s):

Blood Pressure ◽

Total Cholesterol ◽

Weight Status ◽

Cardiovascular Health ◽

Heart Association ◽

Health Behaviours ◽

Intima Media Thickness ◽

Ideal Cardiovascular Health ◽

Lower Total Cholesterol ◽

Ich Score

Abstract Background- The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12.Methods- A total of 1,666 children aged 5-6 years were selected from the prospective ABCD-cohort study. Data on health behaviours and factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. Results- At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend <0.001), lower systolic (p for trend=0.012) and diastolic blood pressure (p for trend=0.011), and lower body mass index (BMI) (p<0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p<0.001) and BMI (p<0.001) only. Conclusion- Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. Further research with longer follow-up is needed to find out whether associations persist into adulthood.

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Abstract 12944: Geographical Variations in Cardiovascular Health in China: A Nationwide Population-based Survey of 74,771 Adults

Circulation ◽

10.1161/circ.142.suppl_3.12944 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Mei Zhang ◽

Yu Shi ◽

Oumin Shi ◽

Zhenping Zhao ◽

Xiao Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Health Behavior ◽

Health Behaviors ◽

Cardiovascular Health ◽

Significant Heterogeneity ◽

Chinese Adults ◽

Ideal Cardiovascular Health ◽

Geographical Variations ◽

Health Factors

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.

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Abstract P216: Prevalence of Life’s Simple Seven Cardiovascular Health Metrics in the Million Veteran Program

Circulation ◽

10.1161/circ.135.suppl_1.p216 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Xuan-Mai T Nguyen ◽

Rachel M Quaden ◽

Rebecca J Song ◽

Yuk-Lam Ho ◽

Kelly Cho ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Total Cholesterol ◽

Plasma Glucose ◽

Cardiovascular Health ◽

Smoking Status ◽

Dietary Factors ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

Us Veterans

Background: While previous studies have reported the prevalence of Life’s Simple Seven (LSS) in the general population, no data exist in a national sample of US veterans. Objective: To assess the prevalence of ideal LSS in a cross-sectional study of 500,000 US Veterans participating in the Million Veteran Program (MVP) from 2011-2016. Methods: We assigned one of three possible values (0=poor, 1=intermediate, 2=ideal) for each of the seven LSS metrics (adiposity /BMI), smoking status, total cholesterol, blood pressure, plasma glucose, diet, physical activity) at baseline using self-reported data and electronic health records. A total score of 0 across all seven metrics indicated overall poor cardiovascular health and a score of 14 indicated ideal cardiovascular health. Results: Complete data on all LSS factors were available for 171,146 Veterans (92% men and mean age 65.5yrs ±11.5 SD). Average LSS score was 6.1 ±1.9. Ideal BMI, smoking status, total cholesterol, blood pressure and plasma glucose (fasting and non-fasting) was present in 23.8%, 30%, 22.2%, 22.5% and 42.9%, respectively, in the study population (Fig). Prevalence of ideal diet was 0.4%. Among dietary factors, recommendation for fruits and vegetables (at least 4.5cups/day) was the least likely to be achieved. Physical activity at the workplace, home or at leisure was reported among 25.6% of Veterans (21.8% intermediate and 3.8% ideal physical activity). Conclusions: Our data show a low prevalence of ideal LSS among Veterans in the MVP, especially diet (0.4%) and physical activity (3.8%). Compared to NHANES 2005-2006 unadjusted prevalence estimates for AHA 2020 goals, Veterans in MVP have a lower prevalence of all ideal LSS metrics except for diet: BMI (23.8 vs 33%), physical activity (3.8 vs 45%), smoking status (30 vs 73%), total cholesterol (22.2 vs 45%) blood pressure (22.5 vs 42%) and glucose (42.9 vs 58%). These findings underscore the need to improve adherence to modifiable lifestyle factors with subsequent reduction in CVD burden among Veterans.

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Abstract P180: Low Prevalence of Ideal Cardiovascular Health in Patients With Severe Hypercholesterolemia in a Largely Rural Population

Circulation ◽

10.1161/circ.141.suppl_1.p180 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Nicole A Groth ◽

Catherine P Benziger

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Sex Differences ◽

Total Cholesterol ◽

Body Mass ◽

Cardiovascular Health ◽

Healthy Diet ◽

Ideal Cardiovascular Health ◽

Health Factors ◽

Low Prevalence

Introduction: The American Heart Association’s ideal cardiovascular health (ICH) score is determined by 3 ideal health factors (normal blood pressure, untreated total cholesterol, and glucose) and 4 ideal health behaviors (non-smoking, normal body mass index, high physical activity, and heart healthy diet). Achieving ICH, defined as meeting 5 of the 7 metrics, decreases risk of cardiovascular disease. Prevalence estimates of ICH in patients with severe hyperlipidemia (SH) living in rural areas are lacking. Hypothesis: We aimed to determine the prevalence of poor, intermediate, and ICH in patients with SH in a large healthcare system (Essentia Health), where over 60% of the population is rural. Methods: The electronic medical record-based SH registry is a cross-sectional cohort study at the Essentia Health of patients who have ever had a low-density lipoprotein - cholesterol value of 190 mg/dL or higher, since 01/01/2000 (n=17,925). Patients were excluded if they did not have a visit at the institution within the past 5 years (n=209) or were outside of the age 20-75 years (n=3,153). Physical activity and healthy diet were not available in the record and were excluded from the score. Patients with missing data were assumed ideal given low clinical suspicion of conditions. Methods: A total of 14,544 (81.1%) of the SH registry patients met inclusion criteria (mean age 63 +13 years; 58.9% female). Figure 1 shows the prevalence of ICH metrics in the total population. Only 3 (0.02%) people met all five of the ideal metrics (score of 10); more females had a score of 8-10 than males (12.5% vs. 9.6%). A total of 13 (0.08%) had a score of 0 (poor) and 3.0% had a score of 0-2 with no sex differences. Not smoking and ideal glucose were the most prevalent health factors. The mean score was 5.6 (+1.6) with no sex differences. Conclusions: There is low prevalence of ICH in patients with SH living in rural populations. The metrics with the lowest prevalence and therefore highest potential for improvement are the health factors: total cholesterol and body mass index.

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Lipidomic Profiling Identifies Signatures of Poor Cardiovascular Health

Metabolites ◽

10.3390/metabo11110747 ◽

2021 ◽

Vol 11 (11) ◽

pp. 747

Author(s):

Irma Magaly Rivas Serna ◽

Michal Sitina ◽

Gorazd B. Stokin ◽

Jose R. Medina-Inojosa ◽

Francisco Lopez-Jimenez ◽

...

Keyword(s):

Blood Pressure ◽

Total Cholesterol ◽

Cardiovascular Health ◽

Fasting Blood Glucose ◽

Heart Association ◽

Population Based ◽

Individual Species ◽

Lipid Profiling ◽

Ideal Cardiovascular Health ◽

Potential Biomarker

Ideal cardiovascular health (CVH) is defined for the presence of ideal behavioral and health metrics known to prevent cardiovascular disease (CVD). The association of circulatory phospho- and sphingo-lipids to primary reduction in cardiovascular risk is unclear. Our aim was to determine the association of CVH metrics with the circulating lipid profile of a population-based cohort. Serum sphingolipid and phospholipid species were extracted from 461 patients of the randomly selected prospective Kardiovize study based on Brno, Czech Republic. Lipids species were measured by a hyphenated mass spectrometry technique, and were associated with poor CVH scores, as defined by the American Heart Association. Phosphatidylcholine (PC), phosphatidylethanolamine (PE), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE) species were significantly lower in ideal and intermediate scores of health dietary metric, blood pressure, total cholesterol and blood fasting glucose compared to poor scores. Current smokers presented higher levels of PC, PE and LPE individual species compared to non-smokers. Ceramide (Cer) d18:1/14:0 was altered in poor blood pressure, total cholesterol and fasting blood glucose metrics. Poor cardiovascular health metric is associated with a specific phospho- and sphingolipid pattern. Circulatory lipid profiling is a potential biomarker to refine cardiovascular health status in primary prevention strategies.

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Abstract P316: Very Low Prevalence of Ideal Cardiovascular Health in Young Adults Studying at the Université de Sherbrooke

Circulation ◽

10.1161/circ.125.suppl_10.ap316 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Marie-France Hivert ◽

Myriam Doyon ◽

Geneviève Forget ◽

Guillaume Lacerte ◽

Melissa Labonté ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Young Adults ◽

Total Cholesterol ◽

Fruits And Vegetables ◽

Cardiovascular Health ◽

Current Guideline ◽

Ideal Cardiovascular Health ◽

Dietary Component ◽

Low Prevalence

Introduction: In 2010, the American Heart Association (AHA) published a special report to define and set national goals for cardiovascular health promotion and disease reduction (2020 Strategic Impact Goals). Ideal cardiovascular health was defined based on seven metrics including both ideal health behaviors (nonsmoking, body mass index &lt 25 kg/m2, physical activity at goal levels, and pursuit of a diet consistent with current guideline recommendations) and ideal health factors (untreated total cholesterol &lt 200 mg/dL [5.2 mmol/L], untreated blood pressure &lt 120/ &lt 80 mm Hg, and fasting blood glucose 8h of overnight fasting, using standardized procedures. Resting blood pressure was measured in the sitting position (twice, using the average for analyses). Physical activity was assessed by a validated questionnaire. Dietary intake was assessed by 3-day food diary; the average per day or the estimations per week were used accordingly to the specific dietary component recommendation. Results: The cohort was composed of young adults (20.6 ± 2.9 years old), mainly of European origin (97.8%), and 74.6% were female. Overall, only one participant (0.4%) achieved ideal cardiovascular health (all seven ideal health metrics). Very few participants (2.2%) achieved ideal healthy diet score (4-5 components /5). Investigating individual dietary component, our results showed that 9.4% consumed ≥ 4.5 cups/day of fruits and vegetables, 25.7% had ≥ two servings/week of fish, 14.5% reported ≥ three servings/day of fiber-rich whole grains, 8.0% consumed &lt 1500g/day of sodium, and 75.4% reported drinking &lt 36oz / week of sugar-sweetened beverages. Concerning the other health metrics, 22.8% achieved the recommended level of physical activity, 93.8% were non-smokers, 75.7% had a BMI &lt 25kg/m2, 42.4% had a blood pressure in the ideal range ( &lt 120/ &lt 80 mmHg), 99.6% had a normal fasting glucose ( &lt 5.6 mmol/L), and 42.4% had a total cholesterol &lt 5.2 mmol/L. Conclusions: The prevalence of ideal cardiovascular health is very low, even in a population of young adults interested in healthy lifestyle. The low prevalence is mainly dependent on the healthy dietary score where the biggest challenges seem to be consumption of fruits and vegetables, and limiting sodium intake. Public health actions are seriously needed to improve these health metrics.

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Low prevalence of ideal cardiovascular health in Peru

Heart ◽

10.1136/heartjnl-2017-312255 ◽

2018 ◽

Vol 104 (15) ◽

pp. 1251-1256 ◽

Cited By ~ 14

Author(s):

Catherine P Benziger ◽

José Alfredo Zavala-Loayza ◽

Antonio Bernabe-Ortiz ◽

Robert H Gilman ◽

William Checkley ◽

...

Keyword(s):

Cardiovascular Health ◽

American Heart ◽

Vegetable Consumption ◽

Prevalence Ratio ◽

Health Behaviours ◽

Resource Poor Setting ◽

Ideal Cardiovascular Health ◽

Ich Score ◽

Low Prevalence ◽

The Ideal

BackgroundThe prevalence of and factors associated with ideal cardiovascular health (ICH) by sociodemographic characteristics in Peru is not well known.MethodsThe American Heart Association’s ICH score comprised 3 ideal health factors (blood pressure, untreated total cholesterol and glucose) and 4 ideal health behaviours (smoking, body mass index, high physical activity and fruit and vegetable consumption). ICH was having 5 to 7 of the ideal health metrics. Baseline data from the Center of Excellence in Chronic Diseases, a prospective cohort study in adults aged ≥35 years in 4 Peruvian settings, was used (n=3058).ResultsNo one met all 7 of ICH metrics while 322 (10.5%) had ≤1 metric. Fasting plasma glucose was the most prevalent health factor (72%). Overall, compared with ages 35–44 years, the 55–64 years age group was associated with a lower prevalence of ICH (prevalence ratio 0.54, 95% CI 0.40 to 0.74, P<0.001). Compared with those in the lowest tertile of socioeconomic status, those in the middle and highest tertiles were less likely to have ICH after adjusting for sex, age and education (P<0.001).ConclusionThere is a low prevalence of ICH. This is a benchmark for the prevalence of ICH factors and behaviours in a resource-poor setting.

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Abstract 035: Ideal Cardiovascular Health in Young Adulthood and Cognitive Functioning 25 Years Later: The CARDIA Study

Circulation ◽

10.1161/circ.125.suppl_10.a035 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Jared P Reis ◽

Catherine M Loria ◽

Lenore J Launer ◽

Stephen Sidney ◽

Kiang Liu ◽

...

Keyword(s):

Young Adulthood ◽

Cardiovascular Health ◽

Verbal Learning ◽

Stroop Test ◽

Digit Symbol Substitution Test ◽

Ideal Cardiovascular Health ◽

Auditory Verbal Learning ◽

Health Factors ◽

Symbol Substitution ◽

Learning Test

Background: Accumulating evidence suggests the presence of cardiovascular risk factors in middle-age is associated with later adulthood cognitive dysfunction; however, the consequences of suboptimal cardiovascular health in young adulthood are unclear. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) Study is a cohort of white and black men and women who were 18-30 years when a series of health behaviors (smoking status, body mass index, physical activity, diet) and health factors (total cholesterol, blood pressure, fasting glucose) were measured during a baseline clinic examination in 1985-1986. Included in the current study were 2,577 participants who completed an examination 25 years later when a cognitive battery to assess psychomotor speed (Digit Symbol Substitution Test [DSST]), executive function (modified Stroop Test), and verbal memory (Rey Auditory Verbal Learning Test [RAVLT]) were administered. Ideal levels for each behavior and factor were defined according to the 2020 American Heart Association Goals for Cardiovascular Health. Associations were adjusted for age, sex, race, midlife educational attainment, and study center. Results: At baseline, the percentage of participants with 0-1, 2, 3, 4, 5, and 6-7 ideal health factors were 1.2%, 7.2%, 19.6%, 34.9%, 29.2%, and 7.8%, respectively. Adjusted mean DSST and RAVLT scores were higher among those with a greater number of ideal health factors ( Table ). Each additional factor at the ideal level was associated with a 0.78-point higher DSST score (95% CI: 0.28 to 1.28) and a 0.13-point higher memory score (95% CI: 0.02 to 0.25). Results did not differ by race or sex (p-interaction > 0.05). The ideal cardiovascular health score was not associated with performance on the Stroop Test. Conclusion: In this population-based sample, ideal cardiovascular health in young adulthood was independently associated with cognitive functioning in midlife. Table. Adjusted * mean (standard error) cognitive function scores at Year 25 by number of ideal health behaviors and factors at baseline: CARDIA (n=2,577). No. of Ideal Health Factors at Baseline (% of population) 0-1 (1.2%) 2 (7.2%) 3 (19.6%) 4 (34.9%) 5 (29.2%) 6-7 (7.8%) p-trend DSST 70.0 (2.5) 65.7 (1.0) 68.7 (0.6) 69.4 (0.5) 70.0 (0.5) 69.9 (1.0) 0.003 Stroop Test 21.5 (1.6) 21.2 (0.6) 21.0 (0.3) 20.6 (0.3) 20.6 (0.3) 20.4 (0.5) 0.14 RAVLT 7.4 (0.6) 7.6 (0.2) 8.0 (0.1) 8.2 (0.1) 8.3 (0.1) 8.1 (0.2) 0.02 * Adjusted for age, sex, race, midlife educational attainment, and study center. DSST=Digit Symbol Substitution Test; RAVLT=Rey Auditory Verbal Learning Test

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Abstract T P345: Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality among Middle Aged Men in Korea: The Seoul Male Cohort Study

Stroke ◽

10.1161/str.45.suppl_1.tp345 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Ji Young Kim ◽

Chul Woo Rhee ◽

Young-Jin Ko ◽

Byung-Joo Park ◽

Dong-Hyun Kim ◽

...

Keyword(s):

Blood Pressure ◽

Blood Glucose ◽

Health Behaviors ◽

Cardiovascular Health ◽

Fasting Blood Glucose ◽

Asian Population ◽

Heart Association ◽

Middle Aged ◽

Ideal Cardiovascular Health ◽

Cvd Mortality

Background: In Korea, Cerebrovascular and cardiovascular diseases (CVD) were the second leading cause of deaths in 2011. In 2010, the American Heart Association (AHA) published cardiovascular health metrics (CVHM) aimed at reducing deaths from all CVDs and stroke, and improving the cardiovascular health of the population as a whole. Despite their implications, the AHA’s metrics have not been broadly studied or previously applied to an Asian population. Objectives: This study estimated the combined association of cardiovascular health behaviors on the risk of all-cause and CVD mortality in middle-aged men in Korea. Methods: In total, 14,533 men aged 40-59 years were enrolled in 1993 and followed-up through 2011. CVHM defined the following lifestyles proposed by the AHA: smoking, physical activity, BMI, healthy diet score, total cholesterol, blood pressure, and fasting blood glucose. The CVHMs score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior vs. 0 points otherwise. All subjects were classified as meeting 0-7 CVHM. The principal outcome variables were all-cause and CVD mortality. The Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of cardiovascular health behavior, and CVHMs score. PARs were calculated from significant CVHMs. Results: During 266,482.8 person-years of follow-up, there were 1,314 deaths in total. Current smoking, blood pressure, and fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 81% (95% CI, 50-94%) and 96% (66-99%) for all-cause and CVD mortality, respectively. More ideal CVHM was significantly associated with lower risks of all-cause and CVD mortality ( p-trend<.0001 ). The adjusted HRs of the groups with 6-7 vs. 0-2 ideal CVHM were 0.49 (0.35-0.70) and 0.23 (0.10-0.57) for all-cause and CVD mortality, respectively. Conclusions: Among ideal cardiovascular health behaviors, non-smoking, normal blood pressure, and recommended fasting blood glucose levels associated with reduced risks of all-cause and total CVD mortality. There was a strong trend towards decreased all-cause and CVD mortality risk with increasing the number of ideal CVHMs.

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