Abstract
The American Heart Association has outlined seven modifiable cardiovascular health (CVH) metrics. However, the sex and age disparities in the association between those CVH metrics and ischemic heart disease (IHD) prevalence are unclear. Our study sought to examine the possible sex and age variations in the association between CVH metrics and IHD prevalence using an Australian nationally representative survey. We used the core sample of the 2011–2012 Australian Health Survey, and 7499 adults with fasting plasma glucose (FPG) and total cholesterol values were included. We used Poisson regression analysis to measure the associations between individual metrics and IHD prevalence. Our study used both stratification and interaction analyses to compare the magnitude of associations between sex and age groups. Then, we calculated the population attributable fractions to measure the contribution of each metric to IHD prevalence. In addition, we applied logistic regression analysis to examine the influences of ideal CVH metrics number on IHD prevalence and used stratification and interaction analyses. Body mass index, physical activity, blood pressure, and FPG have greater effects on IHD prevalence in young adults compared to older adults. We failed to detect the sex variations in CVH metrics and IHD prevalence. The ideal CVH metrics number was inversely correlated to IHD prevalence and it has similar effects in four subgroups. These CVH metrics do not explain the sex and age disparities in IHD prevalence and the topic need further explorations.
Highlights
Ischemic heart disease (IHD) is one common type of cardiovascular disease (CVD) and is a significant contributor to deaths worldwide
Overall, weighted 3.3% participants were positive for IHD prevalence (357/7499)
Our results demonstrated that the impacts of high body mass index (BMI), physical inactivity, elevated blood pressure (BP), and elevated fasting plasma glucose (FPG) were more apparent in young adults than in older adults
Summary
Ischemic heart disease (IHD) is one common type of cardiovascular disease (CVD) and is a significant contributor to deaths worldwide. According to the Global Burden of Disease Study, IHD led to nearly 10 million deaths worldwide in the year 2016, which accounted for 17.3% of all deaths [1]. A Chinese cohort found that almost half of the IHD cases could be prevented if the participants adhered to six healthy lifestyle factors, including smoking, alcohol consumption, physical activity, dietary pattern, and body mass index (BMI) [2]. In a US study, six lifestyle factors could explain 73% of coronary heart disease (CHD), another term for IHD, events in a 20-years follow-up period [3]. The American Heart Association (AHA) has outlined seven modifiable metrics [smoking, BMI, physical activity, dietary pattern, total cholesterol (TC), blood pressure (BP), and fasting plasma glucose (FPG)] to define and monitor cardiovascular health (CVH) status in the general population [4]. A few studies have suggested that the strengths of association between modifiable factors and IHD risk differed by age and sex [7,8] while the variations were inconclusive due to very limited studies
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