Abstract P102: Potential U.S. Population Impact Of Low Cardiovascular Health In Terms Of Preventable Loss Of Life-span And Health-span

Abstract

Introduction: Individuals who maintain optimal cardiovascular health (CVH) live a longer, healthier life without cardiovascular disease (CVD). In order to quantify the population burden of sub-optimal CVH, we estimated potential loss of health- and life-span in a nationally representative sample of middle-aged US black and white adults. Methods: We first calculated individual-level composite CVH scores (range 0-14 points), including all 7 AHA-defined CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, glucose, and cholesterol) using data from middle-aged participants (40-49 years) from 3 population-based cohorts. We categorized participants into low (0-6), moderate (7-9), and high (10-14) CVH and used Irwin’s restricted means to estimate years lived free of and with CVD. Next, we determined the contemporary prevalence of low, moderate, and high CVH in middle-aged black and white adults (40-59 years) pooled from 3 NHANES survey cycles (2011-2016). Finally, we generated estimates of CVD-free and overall years of life lost in moderate and low CVH compared to high CVH subgroups, weighted to the US population accounting for the NHANES complex survey design. Results: Of 12,906 participants in the pooled cohort, 23% were black and 56% women. Low and moderate CVH were associated with 4.41±0.02 and 1.86±0.01 fewer healthy years lived without CVD and 2.43±0.02 and 1.09±0.01 fewer overall years of life, respectively. This resulted in a greater proportion of life lived with CVD across all race-sex groups (FIGURE). When weighted to the US population, we estimate that approximately 230.8 (203.5, 258.0) and 97.1 (95% CI 85.6, 108.6) million healthy life years will be lost due to low and moderate CVH, respectively, in middle-aged adults. Conclusions: The projected loss of healthy CVD-free years and total life years due to low and moderate CVH is substantial. Maintenance of optimal CVH into mid-life may represent a significant opportunity to extend healthspan and mitigate disparities in the US population.