Average Cardiovascular Health Research Articles

Association between cardiovascular health and pelvic inflammatory disease: Analyses of the NHANES 2015 to 2018.

While the link between female reproductive function and cardiovascular health (CVH) is well-established, the association between pelvic inflammatory disease (PID) and CVH remains largely unexplored. This study, therefore, sets out to fill this gap in knowledge by investigating the potential relationship between PID and CVH. To ensure the reliability and validity of our findings, data for this cross-sectional study were meticulously collected from the 2015-2018 National Health and Nutrition Examination Survey (NHANES). After applying stringent exclusion criteria, a total of 2442 women were included in the study. The Life Essential 8 (LE8) scoring system, a robust tool developed by the American Heart Association (AHA), was employed to assess the CVH. Logistic regression with multiple variables and smooth curve fitting were utilized to analyze the association. Subgroup and interaction analyses were performed to determine the strength of this association across different demographic groups. The study included 2442 women, with an average CVH score of 66.29 ± 16.27. After accounting for all covariates, each unit increase in CVH score was associated with 2% lower odds of PID prevalence (OR = 0.98, 95% CI: 0.97-0.99). Notably, participants with high CVH had a striking 71% lower odds of PID prevalence compared to those with low CVH. Stratified analyses further revealed a consistent inverse association between CVH score and PID across various subgroups, underscoring the robustness of our findings. The research has uncovered a significant inverse association between CVH and PID. This suggests that improving the CVH level could be a promising strategy for reducing the odds of PID.

Comparison of the associations between Life's Essential 8 and Life's Simple 7 with depression, as well as the mediating role of oxidative stress factors and inflammation: NHANES 2005–2018

BackgroundCardiovascular health (CVH) is closely associated with depression. However, Life's Essential 8 (LE8), a novel CVH measure, has not yet been clearly linked to depression. This study aims to explore the association between LE8 and depression, compare its advantages over Life's Simple 7 (LS7), and investigate the mediating effects of oxidative stress and inflammation. MethodsThis study investigated cross-sectional data of adults aged 20 and above from National Health and Nutrition Examination Survey (NHANES) 2005 to 2018. The LE8 score (ranging from 0 to 100) was derived from the American Heart Association's definition, based on the unweighted average of 8 metrics, classified as low cardiovascular health (CVH) (0–49), moderate CVH (50–79), and high CVH (80–100). Similar to LE8, LS7 scores were categorized into inadequate (0–7), average (8–10), or optimal (11–14) after calculating the unweighted mean of each component. Depression was diagnosed using the Patient Health Questionnaire (PHQ-9), with a score of ≥10 defining depression. Adjusted for sociodemographic factors and other risk factors for depression, weighted logistic regression and restricted cubic spline analysis were used to explore the correlation. Receiver operating characteristic (ROC) curves were used to study the associations between CVH scores and depression. Subsequently, subgroup analysis and sensitivity analysis were conducted, followed by an exploration of the mechanisms involved. ResultsA total of 7 cycles from 2005 to 2018 contained complete data. Weighted logistic regression showed that both LS7 and LE8 were significantly associated with depression. Specifically, for LE8, after adjustment, the risk of depression decreased by 52 % for moderate CVH compared to low CVH (OR: 0.48, 95 % CI: 0.41–0.57, P < 0.0001), while the risk decreased by 80 % for high CVH (OR: 0.20, 95 % CI: 0.15–0.26, P < 0.0001, Ptrend < 0.0001). For LS7, after adjustment, compared with inadequate CVH, the risk of depression decreased by 49 % for average CVH (OR: 0.51, 95 % CI: 0.34–0.78, P = 0.002), and by 55 % for optimal CVH (OR: 0.45, 95 % CI: 0.27–0.74, P = 0.002, Ptrend < 0.0001). Area under ROC curves for predicting depression were 0.672 (95 % CI, 0.66–0.684; P < 0.001) and 0.605 (95 % CI, 0.59–0.619; P < 0.001) for LE8 and LS7 (PDeLong < 0.001), respectively. Sensitivity analysis demonstrated the robustness of the association. GGT and WBC jointly mediated 9.62 % of this association (all P < 0.001). LimitationsThe cross-sectional study cannot infer causality. ConclusionsThe association between Life's Essential 8 and depression was stronger and more practical. Oxidative stress and inflammation mediate this association. Individuals with extremely poor cardiovascular health have a 7-fold increased risk of depression, highlighting the necessity of maintaining at least moderate cardiovascular health.

Higher consumption of ultra-processed food is associated with cardiovascular risk in Korean adults: KNHANES 2016–2018

BackgroundExcessive consumption of ultra-processed foods (UPFs) has been linked to an increased risk of cardiovascular disease. We aimed to investigate the association between the percentage of energy intake from UPFs and the American Heart Association’s cardiovascular health (CVH) metrics in Korean adults.MethodsThis study analyzed adults aged 40 years and older using data from the Korean National Health and Nutrition Examination Survey 2016–2018 (n = 9,351). All foods or beverages reported in a 24-h dietary recall were categorized using the NOVA system, and the percentage of energy from UPFs was calculated. Each CVH metric was scored 0–2 (poor, intermediate, ideal). The sum of six component scores was classified as inadequate, average, or optimum. Multinomial logistic regression models were used to estimate the covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for inadequate and average CVH versus optimum CVH.ResultsThe mean percentage of energy from UPFs was 24.2%. After adjusting for covariates, participants in the highest UPF quartile had 26% higher odds of having inadequate CVH than those in the lowest quartile (OR 1.26, 95% CI 0.94–1.69, P-trend = 0.03). The percentage of energy from UPFs was positively associated with current smoking, physical inactivity, body mass index, and total cholesterol and was inversely associated with blood pressure and fasting glucose.ConclusionThe percentage of energy from UPFs accounted for one-fourth of total calorie intake in Korean adults aged 40 years and older. Higher UPF consumption was associated with poorer CVH, underscoring the potential of limiting UPF consumption as a preventative measure for cardiovascular diseases.

Abstract P656: Household Food Insecurity is Adversely Associated With Ideal Cardiovascular Health in US Adults: An Updated Analysis Using the American Heart Association’s New Life’s Essential 8 Measure

Introduction: Food insecurity, a condition of limited household food availability due to insufficient resources, is a critical social determinant of health. Food insecurity increases the risks for poor physical, behavioral, and mental health outcomes. Cardiovascular disease remains the leading cause of mortality in the US, and adults with food insecurity may face a high burden of cardiovascular disease risk. This study aimed to examine the associations between household food security status and ideal cardiovascular health (CVH), defined using the American Heart Association (AHA)’s new Life’s Essential 8 measure. We hypothesized that greater severity of food insecurity will be associated with lower overall cardiovascular health. Methods: Data came from 14,619 adults ≥20 years from the 2013-2018 National Health and Nutrition Examination Surveys. Food security was measured using the 18-item Household Food Security Survey Module, and categorized into households with high, marginal, low, and very low food security. Per AHA criteria, ideal CVH was calculated as scores (0-100) indicating the attainment of standards for diet, physical activity, smoking, sleep, body mass index, blood lipids, blood glucose, and blood pressure. Overall CVH was calculated as the unweighted average score across the eight metrics and overall average CVH score ≥80 was considered high CVH. We used linear and logistic regression models to examine the associations between household food security and ideal CVH outcomes, adjusting for sociodemographic characteristics. Complex survey weights were applied to all analyses. Results: In the sample, 72.7% of adults had high food security, 10.0% had marginal food security, 10.4% had low food security, and 6.8% had very low food security. The mean overall CVH score was 68.8 (SE 0.3), ranging from 70.2 (SE 0.3) for high food security to 62.7 (SE 1.8) for very low food security. After multivariate adjustment, marginal food security (β= -1.5, 95% CI -2.9, -0.1), low food security (β= -3.0, 95% CI -4.4, -1.7), and very low food security (β= -4.7, 95% CI -6.4, -3.0) were each associated with lower overall CVH scores when compared to high food security ( P-trend&lt;0.0001 ). These associations were driven by lower mean scores for diet, tobacco, sleep, BMI, and blood glucose with greater severity of food insecurity ( P-trends&lt;0.05 ). Furthermore, low food security (OR 0.57, 95% CI 0.45, 0.74) and very low food security (OR 0.52, 95% CI 0.37, 0.73) were both associated with lower odds of high CVH. Results remained significant in sensitivity analyses restricting the sample to adults with family incomes ≤300% of the federal poverty level. Discussion: Household food insecurity was adversely associated with cardiovascular health metrics in a dose-response fashion. Public health interventions and policies should consider a holistic approach to health promotion among populations with food insecurity.

Ideal cardiovascular health and women's health characteristics in middle aged women free of diagnosed cardiovascular disease. The Polish Norwegian study

Abstract Background Women's reproductive history has been recognized as a cardiovascular risk factor and risk enhancer. Purpose To compare ideal cardiovascular health (CVH) metrics across multiple women's health conditions: parity, breastfeeding, hormonal contraceptive use and menopause status. Methods Cross-sectional data were collected from 7034 women, age 45 to 64 years, free of CVD. Using the 7 American Heart Association criteria, we defined CVH as ideal, intermediate or poor if 6–7, 3–5 or 0–2 ideal metrics were met, respectively. We calculated the CVH score, ranging from 7 (all metrics poor) to 21 (all metrics ideal). Reproductive history was self-reported. We categorized parity in four categories (0, 1–2, 3–4 and 5 or more births). We used general linear models and proportional odds regression models to adjust for covariates and to assess mediation by age, education, income and urban/rural residence. Results Women had a mean age of 55.1 years (SD 5.3). The prevalence of nulliparity was 8.4%, menopause 75.49% and ever use of oral contraceptives, 12.8%. Among non-nulliparous, 88.9% breastfed for a median cumulative duration of 10 months. The prevalence of traditional CVD risk factors was high (obesity 27.6%, uncontrolled blood pressure 39.8%, poor diet 38%). The prevalence of ideal, intermediate and poor CVH was 0.1%, 41.7% and 58.2% respectively. None of the participants had all 7 cardiovascular health metrics at ideal level. Average CVH score was 14.1 (SD 1.9). The prevalence of intermediate CVH scores was highest among nulliparous (27.6%) and decreased with parity (26.72%, 19.87% and 11.42%). There was a statistically significant gradient in mean age-adjusted CVH score across the four parity categories, increasing from multiparous of 5 or more births (13.36, 95% CI 13.13–13.60) to nulliparous (14.24, 95% CI 14.08–14.39). Nulliparous women had 2.9 times greater odds (95% CI 1.91–4.54) of higher CVH scores than multiparous of 5 or more births, after adjusting for age, menopause and use of hormonal contraceptives. Similarly, for women who gave birth 1–2 times and 3–4 times, the adjusted relative odds were 2.65 (95% CI 1.78–3.94) and 1.80 (95% CI 1.2–2.71), respectively. Further adjustment for education, rural residence, personal and/or household finance status attenuated these relations, suggesting a mediating effect. Among non-nulliparous, neither ever breastfeeding or cumulative duration of breastfeeding were associated with CVH scores. Premenopausal women had 1.56 (95% CI 1.33–1.84) times higher odds of higher CVH scores then postmenopausal ones, after full adjustment. Conclusion Women's reproductive history, particularly parity is associated with middle-age cardiovascular health, and part of the association is explained by socio-economic status. These findings suggest the need for early screening and intensification of preventive cardiology interventions in women, especially among vulnerable subgroups. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The Polish-Norwegian Research Fund (PNRF-228-AI-1/07)

Favorable Cardiovascular Health Is Associated With Lower Prevalence, Incidence, Extent, and Progression of Extracoronary Calcification: MESA.

Ideal cardiovascular health (CVH) is associated with a lower incidence of cardiovascular disease. Extracoronary calcification (ECC)-measured at the aortic valve, mitral annulus, ascending thoracic aorta, and descending thoracic aorta-is an indicator of systemic atherosclerosis. This study examined whether favorable CVH was associated with a lower risk of ECC. We analyzed data from MESA (Multi-Ethnic Study of Atherosclerosis) participants aged 45 to 84 years without cardiovascular disease at baseline. ECC was measured by noncontrast cardiac computed tomography scan at baseline and after an average of 2.4 years. Prevalent ECC was defined as an Agatston score >0 at the baseline scan. Incident ECC was defined as Agatston score >0 at the follow-up scan among participants with Agatston score of 0 at the baseline scan. Each CVH metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol, and blood glucose) was scored 0 to 2 points, with 2 indicating ideal; 1, intermediate; and 0, poor. The aggregated CVH score was 0 to 14 points (0-8, inadequate; 9-10, average; 11-14, optimal). We used Poisson and linear mixed-effects regression models to examine the association between CVH and ECC adjusted for sociodemographic factors. Of 6504 participants, 53% were women with a mean age (SD) of 62 (10) years. Optimal and average CVH scores were associated with lower ECC prevalence, incidence, and extent. For example, optimal CVH scores were associated with 57%, 56%, 70%, and 54% lower risk of incident aortic valve calcification, mitral annulus calcification, ascending thoracic aorta calcification, and descending thoracic aorta calcification, respectively. In addition, optimal and average CVH scores were associated with lower ECC progression at 2 years, although these associations were only significant for mitral annulus calcification and descending thoracic aorta calcification. In this multiethnic cohort, favorable CVH was associated with a lower risk of extracoronary atherosclerosis. These findings emphasize the importance of primordial prevention as an intervention to reduce the burden of cardiovascular disease.

Racial, Ethnic, and Geographic Disparities in Cardiovascular Health Among Women of Childbearing Age in the United States.

BackgroundIn the United States, large disparities in cardiovascular health (CVH) exist in the general population, but little is known about the CVH status and its disparities among women of childbearing age (ie, 18–49 years).Methods and ResultsIn this cross‐sectional study, we examined racial, ethnic, and geographic disparities in CVH among all women of childbearing age in the United States, using the 2011 to 2019 Behavioral Risk Factor Surveillance System. Life's Simple 7 (ie, blood pressure, glucose, total cholesterol, smoking, body mass index, physical activity, and diet) was used to examine CVH. Women with 7 ideal CVH metrics were determined to have ideal CVH. Among the 269 564 women of childbearing age, 13 800 (4.84%) had ideal CVH. After adjusting for potential confounders, non‐Hispanic Black women were less likely to have ideal CVH (odds ratio, 0.54; 95% CI, 0.46–0.63) compared with non‐Hispanic White women, and with significantly lower odds of having ideal metrics of blood pressure, blood glucose, body mass index, and physical activity. No significant difference in CVH was found between non‐Hispanic White and Hispanic women. Large geographic disparities with temporal variations were observed, with the age‐ and race‐adjusted ideal CVH prevalence ranging from 4.05% in the District of Columbia (2011) to 5.55% in Maine and Montana (2019). States with low ideal CVH prevalence and average CVH score were mostly clustered in the southern United States.ConclusionsLarge racial, ethnic, and geographic disparities in CVH exist among women of childbearing age. More efforts are warranted to understand and address these disparities.

Abstract P214: Ideal Cardiovascular Health And Progression Of Extra-coronary Calcification In The Multi-ethnic Study Of Atherosclerosis

Background: Ideal cardiovascular health (CVH) is associated with a lower incidence of cardiovascular disease (CVD). Extra-coronary calcification (ECC) – measured at the aortic valve (AVC), mitral annulus (MAC), ascending thoracic aorta (ATAC) and descending thoracic aortic (DTAC) – is an indicator of systemic atherosclerosis. However, the association between ideal CVH and ECC is unknown. This study examined whether favorable CVH was associated with a lower risk of ECC. Methods: We analyzed data from 6,504 men and women aged 45-84 years from MESA, a multi-ethnic cohort free of CVD at baseline. Extra-coronary calcification [AVC, MAC, ATAC and DTAC] was measured by non-contrast cardiac CT scan at baseline and after an average of 2.4 years. Prevalent and incident ECC were defined as an Agatston score &gt;0. Each CVH metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) was scored 0-2 points, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. The maximum CVH score attainable ranged from 0-14 points (inadequate score: 0-8; average: 9-10; optimal: 11-14). We used Poisson regression and linear mixed-effect models to examine the association between CVH and ECC adjusted for age, sex, race/ethnicity, education, income, health insurance and study site. Results: The mean (SD) age of participants was 62 (10) years, 53% were women, 39% White, 12% Chinese American, 26% Black and 22% Hispanic. Optimal and average CVH scores were associated with a lower prevalence and incidence of ECC as well as lower ECC extent at baseline compared to inadequate scores (Table). In addition, optimal and average CVH scores were associated with less ECC progression at 2 years although the associations were only significant for MAC and DTAC. Conclusion: In this multi-ethnic cohort, favorable CVH was associated with a lower risk of developing extra-coronary atherosclerosis. These findings underscore the importance of primordial prevention as an intervention to reduce the burden of CVD.

Abstract 15768: Social Connectedness is Independently Associated With Cardiovascular Health

Introduction: Social connectedness (SC) is an important determinant of maintaining overall health, and the strength of connections with others may influence cardiovascular health (CVH) in part through improvement in cardiovascular disease risk factors. However, there is a lack of research on the role of SC in promoting CVH, as defined by the American Heart Association’s 2020 Impact Goals. The objective of this study is to determine the effect of SC on CVH among adults. Hypothesis: Higher SC will be associated with higher odds of optimal CVH, relative to inadequate CVH. Methods: Data are from the Community of Mine study, a cross-sectional study of 602 participants (42% Hispanic, 56% female, mean age 59 years) living in San Diego County. CVH was based on Life’s Simple 7 using six metrics including smoking, physical activity, body mass index, total cholesterol, blood pressure, and fasting glucose. A 12-point summary score was used to classify participants as having inadequate (0-6), average (7-8), or optimal (9-12) CVH. SC was assessed using a 7-item scale designed to assess social relationships and strength of connections with others (Cronbach’s alpha=0.92). A mean score across all items was generated. Multinomial logistic regression was used to estimate the association between SC and CVH. We adjusted for age, race/ethnicity, governmental cash assistance, income, education, sex, history of medical comorbidities, family history of heart disease, and depressive symptoms. Results: SC was independently associated with CVH (p=0.04). More specifically, a 1-unit increase in mean SC score was associated with a 46% increase in relative odds of having optimal CVH compared to inadequate CVH (OR=1.46, 95% CI: 1.07-1.98), and a 21% increase in relative odds of having average CVH compared to inadequate CVH (OR=1.21, 95% CI: 0.96-1.52). Conclusions: Higher social connectedness is associated with a greater likelihood of having optimal CVH. Individuals’ perceptions of the strength of their relationships could have cardioprotective benefits through promotion of favorable cardiovascular health behaviors and factors.

Abstract P262: Parity and Ideal Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis

Background: Parity (null or grand multiparity) is associated with an increased cardiovascular disease (CVD) risk through several biological pathways. The American Heart Association’s Life’s Simple 7 (LS7) metrics are a useful framework for the promotion of ideal cardiovascular health (CVH). However, the effects of parity on CVH are uncertain. We examined the association between parity and ideal CVH among an ethnically diverse group of middle to older aged women free of CVD at baseline. Methods: We analyzed cross-sectional data of 3,430 women aged 45 to 84 years enrolled in the Multi-Ethnic Study of Atherosclerosis. Parity was self-reported, defined as the total number of live births, and categorized as 0, 1-2, 3, 4 and ≥5. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each categorized into ideal (2 points), intermediate (1 point) and poor (0 points). A total score of 0-8 was considered inadequate; 9-10, average and 11-14, optimal for CVH. The number of metrics in the ideal category was also counted. Multinomial logistic regression was used to examine the association between parity and CVH measured by the score and number of ideal metrics. Results: Mean age (SD) was 62 (10) years. Using women with 1-2 live births as reference, for nulliparous women, the odds of having an average CVH score were 38% higher, while for women with a history of 3 and ≥5 live births, the odds of having optimal CVH were 26% and 54% lower, respectively (Table) . Additionally, women with ≥5 live births were less likely to achieve 5 ideal metrics [OR 0.39 (0.21-0.69)], with a similar trend for 6-7 ideal metrics [0.41 (0.16-1.07)]. Test for interaction by race/ethnicity was not significant (p=0.3). Conclusion: While there was not a strong graded association of parity and CVH scores, our data suggest that women with ≥5 live births are less likely to achieve optimal CVH and greater numbers of ideal metrics. More research will be required to explore the mechanisms by which parity improves or worsens CVH.

Association between cardiovascular health metrics and depression among U.S. adults: National Health and Nutrition Examination Survey, 2007–2014

PurposeThe American Heart Association has identified seven modifiable cardiovascular health (CVH) metrics, including four health behaviors (body mass index, smoking, physical activity, and dietary intake) and three health factors (total cholesterol, blood pressure, and fasting glucose). We sought to examine the association between CVH metrics and depression. MethodsWe analyzed data on 14,561 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2007–2014. Depressive symptoms were assessed using the Patient Health Questionnaire; a score of 0–4, 5–9, and 10 or higher represented no or minimal, mild, moderate or severe depressive symptoms, respectively. CVH was categorized as inadequate, average, or optimum. We used multinomial logistic regression to assess the association between CVH and depression, adjusted for age, gender, race or ethnicity, education, and alcohol use. ResultsPrevalence of inadequate, average, and optimum CVH were 6.1%, 59.7%, and 34.2%; 14.9% and 7.8% of adults had mild and moderate/severe depression, respectively. Compared with participants with optimum CVH, prevalence ratios for moderate or severe depression were 4.39 (95% confidence interval, 3.32–5.80) and 2.64 (2.15–3.24) for those with inadequate and average CVH, respectively. The corresponding prevalence ratios for mild depression were 2.11 (1.77–2.52) and 1.36 (1.19–1.55). The association appeared to be stronger for CVH behaviors. ConclusionsThere was a graded association between CVH metrics, particularly for health behaviors, and mild and moderate/severe depression among U.S. adults.

Cardiovascular health in young adulthood and structural brain MRI in midlife: The CARDIA study.

To examine the association between the American Heart Association (AHA) Life's Simple 7 (LS7) metric and brain structure. We determined cardiovascular health (CVH) according to the AHA LS7, assigning 0, 1, or 2 points for meeting poor, intermediate, or ideal criteria for the 7 components (range 0-14) at baseline (aged 18-30 years in 1985-1986) and year 25 follow-up examination for 518 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) brain MRI substudy. Visit-based CVH score and average score was assessed in relation to percent of intracranial volume of normal tissue of the whole brain, gray matter, and white matter, and abnormal tissue volume of white matter at year 25 using multivariable linear, logistic, and quantile regression, after adjustment for age, sex, race, field center, educational attainment, and alcohol consumption. Mean percentage of whole brain volume, normal gray matter, and normal white matter was 81.3% (±2.5), 42.9% (±2.0), and 38.4% (±2.0). Greater CVH score at baseline (per each additional point at year 0: 0.1%, 95% confidence limits 0.01-0.3; p < 0.05) and average CVH score were associated with greater percentage of whole brain volume (per each additional point in average score: 0.2%, 95% confidence limits 0.04-0.3; p < 0.05). Visit-based or average CVH score was not significantly associated with normal gray or white matter volume or abnormal white matter volume. Maintaining ideal levels of cardiovascular health, determined by the LS7, in young adulthood is associated with greater whole brain volume in middle age but not regional differences in structure.

Abstract P008: Abnormal Ankle-Brachial Index is Inversely Associated with Improved Cardiovascular Health

Background/Objective: An abnormal ankle-brachial index (ABI) strongly correlates with higher mortality in patients with cardiovascular disease however, the inverse link has not been established for cardiovascular (CV) health. The American Heart Association (AHA) aims to improve CV health by 20% by 2020 and has thus proposed the use of CV health metrics (Life’s Simple 7 or LS7). This study examines the relationship of abnormally low ABI with CV health. Methods: We evaluated 5,308 men and women aged ≥40 years, without history of CVD or diabetes mellitus (DM), participating in NHANES from 1999-2004. Abnormally low ABI was defined as ABI&lt; 1.00 which included borderline low [0.91-0.99] and low ABI [&lt;=0.90]). LS7 was scored on a 0-14 point scale and calculated based on poor, intermediate and ideal categories of 7 health components: diet, BMI, smoking, physical activity, blood pressure, glucose and cholesterol. LS7 scores were categorized as inadequate (0-7points), average (8-11) and optimum (12-14) CV health. Ordinal logistic regression models identified associations between abnormal ABI and CV health, with adjustments for sex, age, race/ethnicity, socioeconomic status and hs-CRP. Results: The mean (95% CI) LS7 score was 7.4 (7.3-7.5), with the majority of the population (75.3%) clustered at the lower end of average CV health. Adjusted models demonstrated that, compared to those with inadequate CV health, those with average CV health experienced 28% lower odds of abnormal ABI (OR 0.72, 95% CI; 0.52-0.97). Further improving CV health from inadequate to optimum was associated with 78% lower odds of abnormal ABI (OR 0.22, 95% CI; 0.09-0.57). On examining individual components, only blood pressure was found to be significantly associated with lower odds of abnormal ABI. Those with intermediate, as compared to poor, blood pressure readings showed 32% lower odds of abnormal ABI (OR 0.68, 95% CI; 0.48-0.94) while those with ideal blood pressure showed a 61% lower odds of abnormal ABI (OR 0.39, 95% CI; 0.21-0.72). Discussion/Conclusion: Although those with average CV health experienced lower odds of abnormal ABI, improving CV health to optimum can significantly lower these odds. This suggests that optimizing cardiovascular health, particularly in those who have not yet been affected by CVD or DM, can significantly slow or prevent progression of systemic atherosclerosis.

Leukocyte telomere length and ideal cardiovascular health in American Indians: the Strong Heart Family Study.

Telomere length, a marker of biological aging, has been associated with cardiovascular disease (CVD) and its risk factors. Ideal cardiovascular health (CVH), defined by the American Heart Association (AHA), has also been associated with a reduced risk of CVD, but the relationship between telomere length and ideal CVH is unclear. We measured leukocyte telomere length (LTL) by qPCR in 2568 American Indians in the Strong Heart Family Study (SHFS). All participants were free of overt CVD at enrollment (2001-2003). CVH indices included four behavioral factors (smoking, physical activity, diet, BMI) and three health factors (blood pressure, cholesterol, fasting glucose). Each index was categorized as poor, intermediate, or ideal according to the AHA's guideline. CVH was further categorized into below average (0-1), average (2-3) and above average (≥4) based on the total number of ideal indices. Results showed that, 29, 50 and 21% of study participants had below average, average, and above average CVH, respectively. Participants with above average CVH had significantly longer LTL than those with below average CVH (β=0.034, P=0.042) after adjusting for age, sex, education level, marital status, processed meat consumption, alcohol consumption, and study site. Compared to the U.S. general population, American Indians achieved lower rates for five out of the seven ideal CVH metrics, including smoking, BMI, physical activity, diet, and blood pressure. Achieving four or more ideal CVH metrics was significantly associated with longer LTL. This finding suggests that achieving an ideal CVH may prevent or delay CVD, probably through promoting healthy aging.