Abstract 35: Estimated Impact of Achieving Optimal Cardiovascular Health in the US Adult Population on Cardiovascular Disease Events

Abstract

Introduction: Quantifying the potential impact of achieving optimal cardiovascular health (CVH) in US adults could aid researchers, clinicians, and policymakers in developing and implementing strategies to reduce the burden of cardiovascular disease (CVD). Hypothesis: CVH is suboptimal in US adults. Attaining an optimal level of CVH in all US adults would prevent a substantial number of CVD events. Methods: We pooled individual-level data from 7 US cohort studies (n=30447) included in the Lifetime Risk Pooling Project to estimate annual incidence rates of major CVD (CVD deaths, myocardial infarction, stroke, heart failure) by sex, race, and age. Using data from the National Health and Nutrition Examination Survey 2013 to 2016, we estimated the proportions of US adults in different CVH groups, defined by levels of 7 health factors: smoking status, body mass index, physical activity, dietary pattern, total cholesterol, blood pressure, and fasting glucose. Each factor was scored as ideal (2 points), intermediate (1 point), or poor (0 points). We defined overall CVH as optimal (12-14 points), moderate (9-11 points), or poor (0-8 points). Using the 2 data sources and Monte Carlo simulation, we estimated hazard ratios (HRs) for CVD, population attributable fractions, and the number of CVD events that could be prevented annually if all US adults achieved optimal CVH. Results: An optimal level of CVH was identified in 6.5% (95% CI, 4.5-8.5%) of US adults (Table) and was associated with a lower risk for CVD (HR [95% CI], 0.29 [0.17-0.43]). Our analysis suggests that 70% (95% CI, 55-82%) of all CVD events can be attributed to non-optimal levels of CVH. If US adults attained an optimal level of CVH, 2.0 (95% CI, 1.6-2.3) million CVD events could be prevented annually. Conclusions: The potential impact of achieving an optimal level of CVH in all US adults is considerable, and even a partial improvement would be beneficial. Population- and individual-level strategies to maintain or restore optimal CVH to reduce CVD event rates are highly desirable.