Association between Ideal Cardiovascular Health Metrics and Suboptimal Health Status in Chinese Population

Youxin Wang,Zhongyao Zhao,Di Liu,Manshu Song,Jing Qiu,Xizhu Wang,Hao Wang,Qiaofeng Song,Yong Zhou,Wei Wang,Xiaoxue Liu

doi:10.1038/s41598-017-15101-5

Abstract

Suboptimal health status (SHS) is a physical state between health and illness, and previous studies suggested that SHS is associated with majority components of cardiovascular health metrics defined by American Heart Association (AHA). We investigated the association between SHS and cardiovascular health metrics in a cross-sectional analysis of China suboptimal health cohort study (COACS) consisting of 4313 participants (60.30% women) aged from 18 to 65 years old. The respective prevalence of SHS is 7.10%, 9.18%, 10.04% and 10.62% in the first, second, third and fourth quartiles of ideal cardiovascular health (CVH) metrics (P for trend = 0.012). Participants in the largest quartile of ideal CVH metrics show a lower likelihood of having optimal SHS score compared to those in the smallest quartile (odds ratio (OR), 0.43; 95% confidence interval (CI), 0.32–0.59), after adjusting for age, gender, marital status, alcohol consumption, income level and education. Four metrics (smoking, physical inactivity, poor dietary intake and ideal control of blood pressure are significantly correlated with the risk of SHS. The present study suggests that ideal CVH metrics are associated with a lower prevalence of SHS, and the combined evaluation of SHS and CVH metrics allows the risk classification of cardiovascular disease, and thus consequently contributes to the prevention of cardiovascular diseases.

Highlights

The SHS encompasses 5 characteristics: fatigue, the cardiovascular system, the digestive tract, the immune system and mental status[1]
These studies indicated that SHS is associated with majority of cardiovascular health metrics defined by American Heart Association (AHA)[13]
A prospective cohort study including 42,847 men in America indicated that majority of cardiovascular events may be preventable through adherence to healthy lifestyle practices[14] and another study showed that the number of ideal cardiovascular health (CVH) metrics is a strong predictor of cardiovascular disease and mortality[15]

Summary

Results

Never or quit-smoking >12 months, ideal physical activity and ideal dietary intake were significantly associated with the decreased risk of SHS (OR, 0.70 (95% CI, 0.50–0.99), 0.68 (0.54–0.86) and 0.31 (0.22–0.45) for never or quit-smoking >12 months, ideal physical activity and ideal dietary intake, respectively) after adjusting for age, gender, marital status, alcohol use, income level, education level, and other 6 ideal cardiovascular metrics. Compared to those with intermediate control of blood pressure (SBP 120–139 mmHg or DBP 80–89 mmHg or treated to goal), ideal blood pressures was showed to associate with increased risk of SHS (OR, 1.49; 95% CI, 1.17–1.89) in the full adjusted model. Stratified analyses showed that the negative correlation of SHS with ideal dietary intake and positive correlation with ideal blood pressure are consistent in men and women and across different age groups (Table 3)

Discussion

Conclusions

Methods