Ideal Cardiovascular Health in Young Adults With Established Cardiovascular Diseases.

Jane A Leopold,Elliott M Antman

doi:10.3389/fcvm.2022.814610

Abstract

There has been an increase in the prevalence of cardiovascular diseases among young adults in the United States that has been attributed, in part, to a rise in overweight and obesity, use of combustible tobacco and unhealthy diet and exercise patterns. These factors are influenced further by socioeconomic status and other social determinants of health. In the My Research Legacy study, we examined ideal cardiovascular health in young adults aged 18– <50 years with cardiovascular disease using the Life's Simple 7 survey and data from digital health devices. Young adults with cardiovascular disease (n = 349) were older, had a lower socioeconomic status, a higher prevalence of risk factors, and lower Life's Simple 7 Health Scores (6.4 ± 1.5 vs. 7.1 ± 1.5, p < 0.01) compared to young adults without cardiovascular disease (n = 696). Analysis of digital health device data revealed that young adults with cardiovascular disease performed a similar number of weekly minutes of moderate and vigorous exercise as those without disease leading to similar ideal activity scores. Young adults with cardiovascular disease also shared similarities in modifiable risk factors with adults aged ≥50 years with cardiovascular disease (n = 217), including weight, dietary habits, and weekly minutes of exercise. Latent class analysis identified two phenogroups of young adults with cardiovascular disease: phenogroup 1 was characterized by more advantageous cardiovascular health factors and behaviors resulting in higher Life's Simple 7 Health Scores than phenogroup 2 (7.4 ± 1.2 vs. 5.5 ± 1.1, p < 0.01). These findings in young adults with cardiovascular disease may inform the design of behavioral and therapeutic interventions in the future to decrease cardiovascular morbidity and mortality.

Highlights

There has been a significant decline in mortality attributable to cardiovascular diseases, there is accumulating evidence that this benefit may be age-specific and less applicable to younger patients [1, 2]
Young adults with cardiovascular disease were slightly older (39.8 ± 6.7 vs. 35.3 ± 8.4 yrs, p < 0.01), more likely to be Black, Asian, or Hispanic race and ethnicity and had a lower affluence index compared to individuals without cardiovascular disease (Table 1)
Using digital health device measured exercise data resulted in a similar distribution of participants with intermediate and ideal activity scores between the groups. Participants in both groups recorded a similar number of daily steps (Table 3), suggesting a similar amount of contact time with their digital health devices. In this analysis of ideal cardiovascular health in young adults with cardiovascular disease, we found such individuals were less likely to achieve ideal scores in 5 or more Life’s Simple 7 cardiovascular health and behavior categories and had lower Health Scores compared to young adults without cardiovascular disease

Summary

Introduction

There has been a significant decline in mortality attributable to cardiovascular diseases, there is accumulating evidence that this benefit may be age-specific and less applicable to younger patients [1, 2]. The etiology of the rise in cardiovascular diseases in younger adults is multifactorial and has occurred concomitant with an increase in the proportion of populations that are overweight and obese; have prevalent hypertension, hyperlipidemia, and diabetes mellitus; continue to use combustible tobacco and e-cigarette products; and consume highly processed foods [6–9]. The American Heart Association has prioritized achieving ideal cardiovascular health for all as a 2,030 strategic impact goal with a focus on increasing health equity among populations, overall community, and individual well-being, and decreasing cardiovascular mortality [11, 12]. Ideal cardiovascular health has declined over the past 20 years in communities [16, 18] and an analysis from the National Health and Nutrition Examination Survey (NHANES) estimated that ∼70% of all cardiovascular disease events were related to non-ideal cardiovascular health [19]

Methods

Results

Conclusion