Abstract
In the general population, there is a strong inverse relationship between the number of ideal cardiovascular health (CVH) metrics and the total incidence of cardiovascular diseases and stroke. However, the prevalence of ideal CVH is extremely low and there are few studies on its association with newly found asymptomatic intracranial arterial stenosis (AICAS). Therefore, we performed this prospective study to assess the relationship between the newly found AICAS and ideal CVH metrics in the Chinese community population. Seven ideal CVH metrics of 3,475 participants in the Asymptomatic Polyvascular Abnormalities Community study (APAC) conducted in China (1,962 men and 1,513 women between the ages of 45 and 75 years) were collected. Based on the occurrence of newly found AICAS, all participants were divided into the AICAS group and non-ICAS group. Prevalence of ideal CVH metrics was compared between the two groups. Logistic regression was used to estimate the association of newly found AICAS with ideal CVH metrics. The result was the number of ideal CVH metrics was strongly associated with age, gender, education levels and family income (each P < 0.0001). Among the seven CVH metrics total cholesterol (TC) was the only one showing significant difference between the newly found AICAS group and non-ICAS group in our 2 years observation. Participants with less ideal CVH metrics (≤3) were associated with significantly higher prevalence of AICAS than those with more (>3) ideal CVH metrics (OR, 1.27; P = 0.045). Furthermore, less (≤3) ideal CVH metrics was markedly associated with higher incidence of AICAS for all participants, younger participants (<60 years) (OR, 1.34; P = 0.046) and men participants (OR, 1.53; P = 0.032) after adjustment for gender, age, education level, family income and stroke history. Thus we conclude that participants with newly found AICAS have high prevalence of total cholesterol status, and Individuals with low ideal CVH metrics (≤3) are associated with significantly higher prevalence of asymptomatic ICAS, especially in high-risk population of young and men participants. Therefore, primordial prevention of stroke should also focus on those high-risk populations.
Highlights
No study has evaluated the minimum targeted number of ideal cardiovascular health (CVH) metrics to be adopted for the primordial prevention of ICAS and few studies evaluated the association between newly found asymptomatic intracranial arterial stenosis and CVH metrics in community population
We have performed this prospective study to analyze the effect of every ideal CVH metrics on asymptomatic intracranial arterial stenosis (AICAS), assess the minimum number of ideal CVH metrics to predict AICAS, and provide reliable evidences to screen vulnerable population delay the development of AICAS and achieve primordial prevention of stroke
The number of CVH was significantly associated with the gender (P < 0.0001), age (P = 0.001), education levels (P < 0.0001) and the income of the family (P < 0.0001); but there was no statistic relationship between number of CVH and family history of stroke (P = 0.3999) (Table 1)
Summary
Individualized prescription and minimum targeted number of ideal CVH metrics that can be achieved should be explored. Previous studies in this area are generally of cross-sectional design, and there is possible bias as some individuals might have AICAS already and the ideal CVH metrics parameters have changed. No study has evaluated the minimum targeted number of ideal CVH metrics to be adopted for the primordial prevention of ICAS and few studies evaluated the association between newly found asymptomatic intracranial arterial stenosis and CVH metrics in community population. We have performed this prospective study to analyze the effect of every ideal CVH metrics on AICAS, assess the minimum number of ideal CVH metrics to predict AICAS, and provide reliable evidences to screen vulnerable population delay the development of AICAS and achieve primordial prevention of stroke
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