Favorable Cardiovascular Health Is Associated With Lower Hepatocyte Growth Factor Levels in the Multi-Ethnic Study of Atherosclerosis

Introduction: Hepatocyte growth factor (HGF) is a cytokine released in response to endothelial injury and a potential biomarker of cardiovascular disease (CVD) risk. We examined the association between cardiovascular health (CVH) and HGF in a multi-ethnic cohort of adults free from CVD at baseline.Methods: This cross-sectional study conducted between 2020 and 2021 used MESA baseline examination data (2000–2002) from 6,490 US adults aged 45–84 years. The independent variable was CVH measured by the CVH score and number of ideal metrics. The score was derived from seven metrics: smoking, body mass index, physical activity, diet, total cholesterol, blood pressure and blood glucose. Each metric was scored 0 points (poor), 1 point (intermediate) and 2 points (ideal). The total CVH score ranged from 0 to 14. An inadequate score was 0–8, average, 9–10 and optimal, 11–14. The dependent variable was logarithmically transformed HGF. We used regression analyses to estimate associations between CVH and HGF adjusting for sociodemographic factors.Results: Participants' mean (SD) age was 62 (10) years. Fifty-three percent were female. A one-unit increment in the CVH score was significantly associated with 3% lower HGF levels. Average and optimal CVH scores were significantly associated with 8% and 12% lower HGF levels, respectively, compared to inadequate scores. Additionally, a greater number of ideal metrics was associated with lower HGF levels.Conclusion: Favorable CVH was significantly associated with lower HGF levels in this ethnically diverse cohort. Interventions aimed at promoting and preserving favorable CVH may reduce the risk of endothelial injury as indicated by lower serum HGF levels.

Abstract P008: Ideal Cardiovascular Health And Hepatocyte Growth Factor In The Multi-ethnic Study Of Atherosclerosis

Background: Hepatocyte growth factor (HGF) is a cytokine released in response to vascular injury and a novel biomarker of cardiovascular disease (CVD) risk. However, the relationship between ideal cardiovascular health (CVH) and HGF is unknown. We examined whether ideal CVH is associated with lower HGF levels in a multi-ethnic cohort of adults free from clinical CVD at baseline. Methods: We analyzed data from the MESA study of 6,490 men and women aged 45-84 years. The independent variable was the CVH score derived from 7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure and blood glucose). Each metric was scored 0 points (poor), 1 point (intermediate) and 2 points (ideal). The total CVH score ranged from 0-14. An inadequate score was 0-8, average, 9-10 and optimal, 11-14. The number of ideal metrics was also counted. The dependent variable was logarithmically transformed HGF. We examined the association between the CVH score and HGF using linear regression models adjusted for age, sex, race/ethnicity, education, income, health insurance and study site. Results: The mean (SD) age of participants was 62 (10) years. Fifty-three percent were women. Participants with optimal CVH scores had the lowest HGF concentration [Median (IQR): 807 (678-962) pg/mL] compared to those with average [870 (740-1,036)] and inadequate scores [969 (821-1,159)]. A one-unit increment in the CVH score was significantly associated with a 3% lower HGF concentration (Table). Average and optimal CVH scores were also significantly associated with 8% and 12% lower HGF concentrations, respectively, compared to inadequate scores. Additionally, a greater number of ideal metrics was associated with lower HGF concentrations. Interactions by age, sex and race/ethnicity were not significant. Conclusion: In this ethnically diverse cohort, optimal CVH was significantly associated with lower HGF levels. Interventions aimed at promoting ideal CVH may reduce vascular injury as indicated by lower serum HGF levels.

Abstract P534: Is a Positive Family History of Cardiovascular Diseases Associated With Ideal Cardiovascular Health in the Community? The Polish Norwegian Study

Introduction: Self-reported family history of cardiovascular diseases (FHxCVD) is associated with an increased cardiovascular risk. In contrast to genetic profiling, FHxCVD has the advantage that it reflects not only genetic susceptibility, but also factors related to a shared environment and behaviors. Ideal cardiovascular health (ICVH) is a summary indicator of behavioral and major subsequent biological factors. FHxCVD is presumed to motivate the adoption of a healthy lifestyle, yet little evidence exists to support this hypothesis in a community setting. Hypothesis: We assessed the hypothesis that self-reported family history of cardiovascular diseases is associated with ICVH in a community based study. Methods: We used cross-sectional, baseline data of 10934 participants, age 45 to 64 years free of cardiovascular diseases in an ongoing cohort study (PONS). Data were collected through structured questionnaires and fasting blood samples. Ideal cardiovascular health was defined according to the American Heart Association criteria (7 metrics assessed at 3 levels: ideal, intermediate, and poor). FHxCVD was self-reported, based on three questions inquiring about coronary heart disease, stroke, hypertension in parents and siblings. We considered a positive FHxCVD if an affirmative answer to any of these three questions was reported. We used multivariable logistic models and adjusted for age, sex, education, place of residence, health care services. Results: The prevalence of poor CVH (0-2 ideal metrics) was 63% and of ideal CVH (6, 7 ideal metrics) was 0.07%. The prevalence of a positive FHxCVD was 77%. Mean (SD) for ICVH score was 2.20 (1.06), with no difference between those with positive and negative FHxCVD. A positive FHxCVD was associated with increased odds of a poor cardiovascular health (0-2 health components), OR (95%CI) 1.12 (1.01-1.23), after adjusting for age, sex, education, rural residence and health care services. Among participants with known history of hypertension, having a positive family history of HTN (but not of CHD or stroke) was associated with lower odds of having their blood pressure controlled (OR 0.83 , 95%CI 0.71-0.96), after multivariable adjustment. Conclusion: In this community-based study we found that self-reported FHxCVD is not accompanied by healthy behaviors. In spite of its personal value, simple knowledge of one’s FHxCVD may not suffice as motivator for lifestyle changes.

P2493Change in cardiovascular health and incident type 2 diabetes and prediabetes: The Whitehall II Study

Background Most previous studies on cardiovascular health (CVH) and incident type 2 diabetes (T2D) used a single measure of CVH and none investigated the association with incident prediabetes. This study aimed to examine whether changes in CVH are associated with incident T2D and prediabetes. Methods Within the prospective Whitehall II study, CVH was examined serially every 5 years from 1991/93 until 2015/16. Subjects with 0–2, 3–4 and 5–6 ideal metrics of CVH from the American Heart Association (non-smoking, and ideal levels of body mass index, physical activity, diet, blood pressure, and total cholesterol, fasting glycaemia was not considered),were categorized as having low, moderate or high CVH. Results There were 6234 participants without prior cardiovascular disease and T2D (mean age 49.8±6.0 years, 70% male) including 5015 who were additionally free of prediabetes (49.6±6.0 years, 67% male) at baseline. Over a median follow-up of 24.8 (IQR 24.0 to 25.2) years, 895 and 1703 incident cases of T2D and prediabetes occurred respectively. Change in CVH between 1991/93 and 2002/04 was calculated among 4470 participants without CVD and T2D in the interval, and among 2798 participants additionally free of prediabetes. In multivariate analysis, compared to those with stable low CVH, risk of T2D was lower in those with initially high CVH (HR=0.23; 0.09, 0.56), those who had persistently moderate CVH or changed from moderate to high CVH (moderate-moderate/high; HR=0.42; 0.33, 0.54), low-moderate/high (HR=0.50; 0.36, 0.69) and moderate-low (HR=0.63; 0.48, 0.83). Results were similar for prediabetes, but effect sizes were smaller. Conclusions Among participants without previous CVD, T2D or prediabetes, change in CVH was related to the risk of incident T2D and prediabetes.

Cardiovascular health and sleep disturbances in two population-based cohort studies

ObjectiveWe aimed to investigate the association between cardiovascular health (CVH), as defined by the American Heart Association, and several sleep disturbances.MethodsTwo community-based cohorts, the Paris Prospective Study 3 (PPS3, France, n=6441) and the CoLaus study (Switzerland, n=2989) were analysed. CVH includes 7 metrics which all can be classified as poor, intermediate and ideal. Global CVH score was categorised into poor (0–2 ideal metrics), intermediate (3–4 ideal metrics) and ideal (≥5 ideal metrics). Associations between global CVH and self-reported sleep disturbances (proxy of sleep-disordered breathing [SDB], excessive daytime sleepiness, insomnia symptoms and short/long sleep duration) and SDB severity measured by polysomnography (PSG) were investigated. Adjusted OR/relative risk ratio (RRR) and 95% CIs were estimated. Subjects with previous cardiovascular disease were excluded.ResultsCompared with poor CVH, subjects with intermediate and ideal global CVH had lower odds of self-reported SDB in both cohorts (ORs 0.55; 95% CI 0.44 to 0.68 and 0.35; 95% CI 0.22 to 0.53, respectively) and had lower SDB severity measured by PSG (RRR 0.07; 95% CI 0.02 to 0.20) in CoLaus. Subjects with intermediate and ideal global CVH had lower odds of excessive daytime sleepiness in PPS3 (ORs 0.82; 0.72 to 0.95 and 0.80; 0.82 to 1.02, respectively). No consistent associations were found between CVH and sleep duration or insomnia symptoms.ConclusionsHigher levels of CVH are associated with lower odds of SDB and excessive daytime sleepiness. However, causal interpretation cannot be made and associations might be bidirectional.

Abstract P267: Brain Health and Ideal Cardiovascular Health. The Polish Norwegian Study (PONS)

Introduction: The relation between brain- and cardiovascular health has been mainly described through cognitive function. Less is known about the relation of ideal cardiovascular health (CVH) and other brain health characteristics. Hypothesis: We assessed the hypothesis that cardiovascular health is associated with brain health constructs: depressive symptoms, sleep quality and duration, self-rated health. As an additional exposure we investigated excessive TV watching, considered an addictive behavior. Methods: We used cross-sectional, baseline data of 10687 participants, age 45 to 64 years free of cardiovascular diseases in an ongoing cohort study (PONS). Data were collected through structured questionnaires and fasting blood samples. Ideal CV health was defined according to the American Heart Association criteria (7 metrics assessed at 3 levels: ideal, intermediate, and poor). Brain health was assessed as: 1) depressive mood (PHQ questionnaire, scale 0-7); 2) sleep hours; 3) self-rated overall health (SRH) (1 item, on a scale from 1 to 10); 4) hours watching TV. We used multivariable logistic models and adjusted for age, sex, education, place of residence, antidepressant medication use and past depressive episodes. Results: The prevalence of poor CVH (0-2 ideal metrics) was 63% and of ideal CVH (6, 7 ideal metrics) was 0.07%. Reporting 4 or more current depressive symptoms was associated with poor CVH (OR, 95%CI 1.13, 1.02-1.27) after multivariable adjustment. The relation was mainly driven by somatic affective rather than cognitive affective depressive symptoms. Difficulties falling asleep or sleep duration were not associated with CVH after controlling for depression. Watching TV more than 20h/week was associated with poor CVH (OR 1.40, 95% 1.27-1.55) after multivariable adjustment. A SRH score of 6 or lower was associated with poor CVH (OR 1.33, 95% CI 1.22-1.46) after multivariable adjustment. We observed similar relations in a sensitivity analysis after excluding those taking current antidepressant medication. Conclusion: In this community-based study we found that there is a moderate association between poor cardiovascular health and current depressive symptoms, independent of past depression episodes or antidepressant treatment. In addition to Life’s Simple 7, monitoring depressive symptoms, sleep, self-rated-health and/or addictive TV-watching may benefit both brain- and heart wellness.