Cardiovascular Health Promotion Research Articles

Is It Possible to Train the Endothelium?—A Narrative Literature Review

This review provides an overview of current knowledge regarding the adaptive effects of physical training on the endothelium. The endothelium plays a crucial role in maintaining the health of vessel walls and regulating vascular tone, structure, and homeostasis. Regular exercise, known for its promotion of cardiovascular health, can enhance endothelial function through various mechanisms. The specific health benefits derived from exercise are contingent upon the type and intensity of physical training. The review examines current clinical evidence supporting exercise’s protective effects on the vascular endothelium and identifies potential therapeutic targets for endothelial dysfunction. There is an urgent need to develop preventive strategies and gain a deeper understanding of the distinct impacts of exercise on the endothelium.

Optimization and mechanism analysis of photosynthetic EPA production in Nannochloropsis salina: evaluating the effect of temperature and nitrogen concentrations

Microalgae, recognized as sustainable and eco-friendly photosynthetic microorganisms, play a pivotal role in converting CO2 into value-added products. Among these, Nannochloropsis salina (Microchloropsis salina) stands out, particularly for its ability to produce eicosapentaenoic acid (EPA), a crucial omega-3 fatty acid with significant health benefits such as anti-inflammatory properties and cardiovascular health promotion. This study focused on optimizing the cultivation conditions of Nannochloropsis salina to maximize EPA production. We thoroughly investigated the effects of varying temperatures and nitrogen (NaNO3) concentrations on biomass, total lipid content, and EPA proportions. We successfully identified optimal conditions at an initial NaNO3 concentration of 1.28 g.L-1 and a temperature of 21°C. This condition was further validated by response surface methodology, which resulted in the highest EPA productivity reported in batch systems (14.4 mg.L-1.day-1). Quantitative real-time PCR and transcriptomic analysis also demonstrated a positive correlation between specific gene expressions and enhanced EPA production. Through a comprehensive lipid analysis and photosynthetic pigment analysis, we deduced that the production of EPA in Nannochloropsis salina seemed to be produced by the remodeling of chloroplast membrane lipids. These findings provide crucial insights into how temperature and nutrient availability influence fatty acid composition in N. salina, offering valuable guidance for developing strategies to improve EPA production in various microalgae species.

Association of Cardiovascular Health in Young Adulthood with Long-Term Blood Pressure Trajectories.

Cardiovascular health (CVH) in young adulthood (YA) has been associated with cardiovascular outcomes in older age. However, little is known about the relationship between YA CVH and mid-life BP trajectories. Baseline CVH (defined by 7 of AHA's Life's Essential 8 [LE8] metrics, excluding BP) was measured in YA with individual metrics scored and averaged as a composite LE8 score. Categorical CVH status was defined as high, moderate, and low. Latent class analysis was used to identify trajectories of mid-BP (mean of SBP and DBP) from average ages 35 to 55 years. Multinomial logistic regression was used to estimate the association of YA CVH status (continuously and categorically) with mid-life BP trajectory group membership. There were 3,688 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study in YA with follow-up data for mid-life BP trajectories. We observed 3 BP trajectory groups, labeled as Persistently-Low, Middle, and High-Increasing. On average, each 10-points higher baseline LE8 score (mean [SD] of 73.5 [13.1]) in YA was associated with adjusted odds ratios of 0.78 (95% CI, 0.72-0.84) for membership in the Middle and 0.65 (0.57-0.73) for membership in the High-Increasing trajectory groups. Compared with categorical low CVH status at baseline, those with high CVH were significantly less likely to be in the Middle and High-Increasing BP trajectory groups. Moderate or low CVH status in YA is associated with elevated mid-life BP trajectory. These data suggest that young adult CVH promotion may be important for primordial prevention of hypertension.

Cardiovascular Health, Race, and Decline in Cognitive Function in Midlife Women: The Study of Women's Health Across the Nation.

Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife. Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women's Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life's Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH. In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.

Role of cardiovascular health factors in mediating social inequalities in the incidence of dementia in the UK: two prospective, population-based cohort studies

The contribution of modifiable risk factors to social inequalities in dementia, observed in longitudinal studies, remains unclear. We aimed to quantify the role of cardiovascular health factors, assessed using Life's Essential 8 (LE8) score, in mediating social inequalities in incidence of dementia and, for comparison, in incidence of stroke, coronary heart disease, and mortality. In this prospective, population-based cohort study, we collected data from the UK Whitehall II Study and UK Biobank databases. Participants were included if data were available on SEP, outcomes and LE8 (smoking, physical activity, diet, body mass index, blood pressure, fasting blood glucose, lipid levels, sleep duration). The primary outcome was incident dementia and secondary outcomes were stroke, coronary heart disease, and mortality. Outcomes were derived from electronic healthcare records. Socioeconomic position (SEP) was measured by occupation in Whitehall II and education in UK Biobank. Counterfactual mediation analysis was used to quantify the extent to which LE8 score explained the associations of SEP with all outcomes. Analyses involved Cox regression, accelerated failure time models, and linear regression; and were adjusted for age, sex, and ethnicity. Between 10.09.1985 and 29.03.1988, a total of 9688 participants (mean age±SD 44.9±6.0; 67% men) from the Whitehall II study, and between 19.12.2006 and 01.10.2010, 278,215 participants (mean age±SD 56.0±8.1; 47% men) from the UK Biobank were included. There were 606 and 4649 incident dementia cases over a median (interquartile range) follow-up of 31.7 (31.1-32.7) and 13.5 (12.7-14.1) years respectively in Whitehall II and UK Biobank. In Whitehall II, the hazard ratio was 1.85 [95% CI 1.42, 2.32] for the total effect of SEP on dementia and 1.20 [1.12, 1.28] for the indirect effect via the LE8, the proportion mediated being 36%. In UK Biobank, the total effect of SEP on dementia was 1.65 [1.54, 1.78]; the indirect effect was 1.11 [1.09, 1.12], and the proportion mediated was 24%. The proportions mediated for stroke, coronary heart disease, and mortality were higher, ranging between 34% and 63% in Whitehall II and between 36% and 50% in UK Biobank. In two well-characterised cohort studies, up to one third of the social inequalities in incidence of dementia was attributable to cardiovascular health factors. Promotion of cardiovascular health in midlife may contribute to reducing social inequalities in risk of dementia, in addition to cardiovascular diseases and all-cause mortality. This study used adult measures of SEP, further research is warranted using lifecourse measures of SEP. NIH (RF1AG062553).

Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20-year follow-up was 7.43 per 1000 person-years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40-0.68) and 0.25 (95% CI, 0.14-0.44), respectively, after adjustment for age, sex, education, and study site. Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.

Neuropsychological effects of physical activity in people with depression

Depression, a mental pathology of high prevalence and impact on quality of life, demands complementary therapeutic approaches. The review emphasized the psychological benefits, notably the improvement of mood and self -esteem, resulting from the modulation of neurotransmitters such as serotonin, dopamine, and endorphins, associated with physical activity. Additionally, physical activity influences the endocrine axis, manifesting itself in reducing the production of stress hormones, exemplified by cortisol. However, it is noteworthy that physical activity should not be used as an isolated approach, but as a component of a broader treatment that encompasses psychotherapeutic interventions and eventually drug therapy with antidepressants. Parallel to mental health benefits, physical activity promotes improvements in physical health, contributing to the strengthening of muscles, increased resistance, and promotion of cardiovascular health. In this context, this study demonstrates significant relevance of physical activity as an adjunct in the treatment and prevention of depression, giving a positive impact on various aspects of the individual's global health.

Development of Health Promotion with The Design of Heart Failure Patient Monitoring Instrument

Heart disease, particularly heart failure, is a prevalent chronic condition requiring regular monitoring to maintain patients' well-being. This study aims to develop and validate a monitoring instrument for heart failure patients. A pilot study was conducted in two main stages: instrument development and pre-test post-test on a sample of outpatient heart failure patients at RSU Muhammadiyah Ponorogo from March to May 2023. The validity test revealed 17 valid questionnaire items, with Cronbach’s Alpha values for routine examination, physical activity, and nutrition domains being 0.729, 0.829, and 0.786, respectively, indicating good reliability. Sample testing demonstrated a significant improvement in patient compliance (p < 0.005) and nutritional status (p < 0.05) after cardiovascular health promotion. However, there was no significant change in physical activity. With a combination of high construct validity, good reliability, and strong content validity, the questionnaire proved to be a robust and reliable measurement tool. The findings depict significant changes in compliance and nutritional status among heart failure patients following health promotion interventions, emphasizing the need for further focus on physical activity aspects. These results can contribute to the development of more effective monitoring and care strategies for heart failure patients.

Life's Essential 8 and risk of incident heart failure in community population without cardiovascular disease: Results of the sub-cohort of China PEACE Million Persons Project

ObjectiveThe American Heart Association has introduced the Life's Essential 8 metrics to evaluate and promote cardiovascular health (CVH) and we aimed to evaluate the association of CVH and incident heart failure (HF). MethodsThe China PEACE Million Persons Project is a population-based cardiovascular disease (CVD) screening study. This was a sub-cohort of the project that included individuals free of CVD at baseline. Components and classifications of CVH, including diet, physical activity, smoking status, sleep status, body mass index (BMI), non-high density lipoprotein (non-HDL), blood glucose and blood pressure, were determined based on the Life's Essential 8. CVH status was categorized as poor, intermediate and ideal status. HF cases were identified by linking hospital records. ResultsAmong the cohort (n = 38,571, median age 54 years and women 60.5%), proportion of individuals with poor, intermediate and ideal CVH was 30.7%, 56.9% and 12.4%. After a median follow-up of 3.56 years, the incidence of HF in individuals with poor, intermediate and ideal CVH was 2.5%, 1.1% and 0.5% respectively. Compared to poor CVH, intermediate (adjusted HR: 0.52 [95% CI: 0.43–0.61]) and ideal CVH (adjusted HR: 0.38 [95% CI: 0.26–0.57]) were associated with a lower HF risk. A gradient of association between CVH and HF risk was observed (P-trend<0.001). Ideal physical activity, ideal smoking status, and intermediate and ideal status of BMI, blood glucose and blood pressure were associated with a lower HF risk. ConclusionPoor CVH was associated with an increased risk of HF, and promotion of CVH may help prevent HF development.

Comparing knowledge, attitudes, and practices in cardiovascular disease prevention and health promotion between community and hospital pharmacists in Saudi Arabia: A cross-sectional study

PurposeSaudi Arabia is one of the leading nations in the world in terms of the high frequency of chronic diseases and their associated risk factors. Knowledge and awareness are crucial for pharmacists to play an active role in the prevention of cardiovascular diseases (CVD). The current study assessed the pharmacists' knowledge, attitude, and practice to determine the potential differences with respect to their respective practice settings toward CVD prevention and related health promotions. MethodsIt is a cross-sectional study targeted the registered pharmacists in the Kingdom of Saudi Arabia. An online questionnaire was prepared, and the link was circulated through various social media platforms. Descriptive statistics, multivariate linear regression analysis and chi square test were used to analyze the data accordingly. ResultsA total of 324 pharmacists were included in the study. Among these, 157 (48.4 %) were community pharmacists, and the remaining were hospital pharmacists (51.6 %). No significant differences in knowledge scores were observed between community and hospital pharmacists. The mean attitude score among community and hospital pharmacists was found to be 26.40 ± 5.125 and 25.09 ± 5.393 respectively, which was statistically significant (p = 0.026). Similarly, the total practice scores across the settings were statistically significant (p = 0.02). Gender plays a significant role in terms of knowledge scores among both community and hospital pharmacists (p = 0.016 & 0.029). Gender, professional practice experience, and number of prescriptions handled and prescriptions with CVD medications showed significant differences in the distribution of positive attitudes and good practice frequency between community and hospital pharmacists. ConclusionIt is evident that there is a deficiency in knowledge among hospital pharmacists compared to community pharmacists. Which indicates that there is a need for a rigorous continuous pharmacy education covering the fundamental aspects of CVD primary prevention and health promotion among pharmacists, given more focus on hospital pharmacists.

Association of cardiovascular health with incident heart failure in community population without cardiovascular disease: results of the China PEACE million persons project

Abstract Aim To evaluate the association of cardiovascular health (CVH) with incident heart failure (HF). Methods The China PEACE million persons project is a nationwide, government-funded and population-based cardiovascular disease (CVD) screening study. This was a sub-cohort study of the project that included community-dwelling adults free of CVD. Components of CVH, including diet, physical activity, smoking status, sleep status, body mass index (BMI), non-HDL, blood glucose and blood pressure, were collected using self-report questionnaires. Each component and CVH were categorized as poor, intermediate and ideal status based on the AHA Life’s Essential 8 criteria. HF cases were identified by linking hospital records. Results Among the cohort (n=38571, median age 54 years and women 60.5%), proportion of individuals with poor, intermediate and ideal CVH was 30.7%, 56.9% and 12.4% respectively. After a median follow-up of 3.6 years, the incidence of HF in individuals with poor, intermediate and ideal CVH was 2.5%, 1.1% and 0.5% (P&amp;lt;0.001). Compared to poor CVH, intermediate (adjusted HR: 0.52 [95% CI: 0.43-0.61]) and ideal CVH (adjusted HR: 0.38 [95% CI: 0.26-0.57]) were associated with a lower risk of incident HF. A gradient of association between CVH and risk of incident HF was observed (P-trend &amp;lt; 0.001). Ideal physical activity, ideal smoking status, and intermediate and ideal status of BMI, blood glucose and blood pressure were independently associated with a lower risk of incident HF. Conclusion Poor CVH was independently associated with an increased risk of incident HF and promotion of CVH may have important implications for HF prevention.Graphical abstract

Abstract 17819: Latent Class Analysis of Heart Health in a Marginalized Black Community

BACKGROUND Mounting evidence associates Black American’s experiences of chronic stress with younger age hypertension (HTN) onset, higher prevalence rates, and poorer treatment outcomes. Epigenetic research findings attribute these trends to DNA methylation, commonly referred to as stress related premature biological aging. Guided by the current American Heart Association (AHA) Science Statement on heart health, this health equity study aims to examine positive Black identity as a measure of positive psychological health in Black adults. METHODS Our community-engagement survey measured self-reports of: (1) environmental wellbeing, positive self-regard, spirituality, chronic stress, Black identity, anxiety, depression, anger, and five AHA essential cardiovascular health (CVH) factors: (2) physical activity, fruit, vegetables, smoking tobacco, and sleep. Multivariable linear regressions examined psychological health and CVH as predictors of systolic blood pressure. Latent class analysis (LCA), using ordinal indicators, assessed for latent sample profiles as statistical probabilities of similar responses and sample heterogeneity. RESULTS In a community sample (N=201) of Black adults (age M=46.7, SD=15.9), primarily female (N=141, 69.5%), increases in systolic blood pressure (Mean=134, SD=20.9) were associated with more chronic stress and less environment wellbeing; decreases were associated with less expressed anger. The LCA results show a four-class statistical solution with greater heterogeneity in spirituality, anger, anxiety, and depression. Among the four profiles, two theoretical latent classes for high and low systolic blood pressure were distinct. Low systolic blood pressure is associated with higher levels of environmental wellbeing, physical activity, and self-regard, both more and less spirituality, more positive Black identity, moderate anger, anxiety, and depression, and checking your BP. CONCLUSION In addition to emotion regulation, physical activity, and self-care, our findings support CVH promotion strategies in marginalized communities of Black Americans designed to reduce chronic stress, improve environmental wellbeing, and support positive Black identity.

“O meu coração bate saudável” – Results from a pilot project for health education in Portuguese children

Introduction and objectivesChildhood offers an excellent window of opportunity to start interventions to promote behavioral changes before unhealthy lifestyles become established, leading to cardiovascular diseases. The goal of this pilot educational project for children is the promotion of healthy lifestyles and cardiovascular health. MethodsThis project was implemented in 4th grade children and included teacher-led classroom activities, a lesson given by a cardiologist and a practical lesson with dietitians. The teacher received a manual containing information on the topics to be discussed in class with the pupils and the children received a book that addresses cardiovascular risk factors and prevention. The components included were diet (D), physical activity (PA) and human body and heart awareness (BH). At the beginning and at the end of the schoolyear, a questionnaire was applied to the children to assess knowledge (K), attitudes (A) and habits (H) on these topics. ResultsA total of 73 children from two schools from an urban district public school in Lisbon, in a low to medium income area, participated in the project. Following the intervention, there was a 9.5% increase in the overall KAH score, mainly driven by the PA component (14.5%) followed by the BH component (12.3%). No improvement was observed for component D. The benefits were also more significant in children from a lower income area, suggesting that socioeconomic status is a determinant in the response obtained. ConclusionsAn educational project for cardiovascular health can be implemented successfully in children aged 9 years, but longer and larger studies are necessary.

Uric acid mediated the relationship between obesity and hypertension in children and adolescents: A population‑based cohort study

Background and aimObesity and hyperuricemia (HUA) often coexist and have been widely accepted as risk factors for hypertension, but the role of uric acid (UA) in the relationship between obesity and hypertension remains unknown in children and adolescents. Methods and resultsA total of 7525 subjects aged 6–16 years were from the School-based Cardiovascular and Bone Health Promotion Program (SCVBH) at baseline (2017) and followed up in 2019. Multivariable logistic regression with interaction terms, cross-lagged panel analysis, and causal mediation model were applied to delineate the joint impact of obesity and HUA on hypertension, including the interaction effect, the temporal association, and the mediating effect of UA in the relationship between obesity and hypertension. There were 10.8 % of the participants with normotension at baseline developed hypertension after two years of follow-up. Cross-lagged panel analysis showed that the two-time point association was significant only from baseline BMI to follow-up UA (β1 = 0.302, P < 0.001), but not from baseline UA to follow-up BMI (β2 = 0.002, P = 0.745). Multivariable logistic regression showed that both obesity and HUA increased the risk of hypertension, but no interaction effect between HUA and obesity. The causal mediation analysis found that UA partially mediated the association between BMI and SBP (mediate proportion: 20.3 %, 95 % CI: 17.4–22.9 %) or DBP (mediate proportion: 11.9 %, 95 % CI: 3.9–18.2 %). The results were consistent in the analysis of systolic hypertension rather than diastolic hypertension. ConclusionsIt is mediating effect that UA played in the progress from obesity to hypertension, particularly systolic hypertension in children and adolescents.

Role of community pharmacists in cardiovascular diseases-related health promotion and dyslipidemia management in Malaysia: A nationwide cross-sectional study.

Cardiovascular disease (CVD) is a leading cause of death and disability worldwide, imposing a significant burden on patients and healthcare systems. The role of pharmacists in reducing cardiovascular disease (CVD) is pivotal as they play an essential part in the healthcare team, particularly in medication management and patient education. Pharmacists are well-positioned to contribute to the prevention and control of CVD through various roles, including medication management and patient education. This study aims to investigate the current involvement of community pharmacists in Malaysia, specifically in cardiovascular diseases-related health promotion activities and dyslipidemia management, including their perceived barriers. This cross-sectional survey was conducted among community pharmacists in all 14 states of Malaysia between November 2021 and July 2022. The self-administered survey was shared to relevant groups through various social media platforms. A total of 312 community pharmacists were involved in the survey. Majority of the respondents were females (66%), with a mean age (SD) of 32.9 (8.4) years. Most of the respondents showed satisfactory practice for patient counselling, but improvements are needed particularly in risk assessment and collaborative care aspect. Most of them expressed their interest for dyslipidemia management training (89.4%). Lack of access to medical records (71.2%) and lack of CVD-related educational materials (70.8%) were the two main perceived barriers identified. Community pharmacists in Malaysia provide a satisfactory role in the provision of cardiovascular disease-related health promotion activities, especially in providing patient counselling. Strengthening collaborative care is essential for providing comprehensive and patient-centered intervention in dyslipidemia management. This requires ongoing efforts to address and overcome existing barriers for effective teamwork and coordination among healthcare professionals.

Tick Tock, 30 Seconds to Better Health: Role of Social Media on Cardiovascular Health Promotion.

As social media becomes an integral part of daily life, healthcare organizations and professionals have harnessed these platforms to increase awareness of cardiovascular disease, provide education regarding modifiable risk factors, and to advocate for further research. Social media can empower patients to share personal accounts of living with cardiovascular conditions, and provide access to global online communities for peer support. Healthcare professionals who use social media must navigate engaging with patients, respecting confidentiality, sharing credible information, and maintaining professionalism.

Incorporating principles from commercial advertising into cardiovascular health promotion efforts.

Incorporating principles from commercial advertising into cardiovascular health promotion efforts.

School-Based Cardiovascular Health Promotion in Adolescents

School-based interventions offer an opportunity for health promotion in adolescence. To assess the effect of 2 multicomponent educational health promotion strategies of differing duration and intensity on adolescents' cardiovascular health (CVH). The SI! Program for Secondary Schools is a 4-year cluster randomized clinical intervention trial conducted in 24 secondary schools from Barcelona and Madrid, Spain, from September 7, 2017, to July 31, 2021. Eligible participants were adolescents enrolled in the first grade of secondary school. Schools and their participants were randomized to receive a health promotion intervention (SI! Program) over 4 school years (long-term intervention [LTI], 8 schools, 412 adolescents) or 2 school years (short-term intervention [STI], 8 schools, 504 adolescents) or to receive the standard curriculum (control, 8 schools, 441 adolescents). The primary end point was the between-group difference at 2 and 4 years in the change from baseline of the overall CVH score, as defined by the American Heart Association (range, 0-14 points, with a higher score indicating a healthier CVH profile). Intervention effects were tested with multilevel mixed-effects models. A complete-case intention-to-treat analysis was performed as the primary analysis. Of the randomized students, the study enrolled 1326 adolescents (684 [51.6%] boys, mean [SD] age, 12.5 [0.4] years at recruitment) with a study completion rate of 86.0%. Baseline overall CVH scores were 10.3 points in the LTI group, 10.6 points in the STI group, and 10.5 points in the control group. After 2 years, at halfway through the LTI and at the end of the STI, the difference in the CVH score change was 0.44 points (95% CI, 0.01-0.87; P = .04) between the LTI group and the control group and 0.18 points (95% CI, -0.25 to 0.61; P = .39) between the STI group and the control group. At 4 years, differences for the LTI and STI groups vs control were 0.12 points (LTI: 95% CI, -0.19 to 0.43; P = .42) and 0.13 points (STI: 95% CI, -0.17 to 0.44; P = .38). No adverse events were reported. Overall, the tested school-based health promotion strategies in this randomized clinical trial had a neutral effect on the CVH of the adolescents. Although there was evidence of a marginal beneficial effect at a point halfway through implementation in the LTI group, such a benefit was not noted at 4 years. Further research is warranted into the efficacy of school-based health promotion programs. ClinicalTrials.gov Identifier: NCT03504059.

[Cardiovascular health status of Chinese adults based on "Life's Essential 8" score].

Objective: To assess the cardiovascular health status of adults in China by using the "Life's Essential 8" score, and provide reference for the development and improvement of cardiovascular disease prevention and control policies and measures. Methods: Chronic Disease and Nutrition Surveillance was conducted in 298 counties/districts in 2015 in 31 provinces (autonomous regions, municipalities) across China, multi-stage stratified cluster random sampling was used to select 45 households in each village or neighborhood, and 20 households were further selected to conduct dietary surveys. In this study, a total of 70 093 adults aged ≥20 years who completed the dietary survey and had complete information were included, their cardiovascular health status were assessed by using the "Life's Essential 8" score, a cardiovascular health scoring standard released by the American Heart Association in 2022. All results were adjusted using complex design-based sampling weights to achieve a better estimate of the population. Results: In 2015, the overall cardiovascular health score of Chinese adults aged ≥20 years was 73.3±12.6, the score was significantly higher in women (77.9±11.6) than in men (68.7±11.8), and higher in urban area (74.5±12.8) than in rural area (71.9±12.2), the differences were significant (P<0.001). It was estimated that about 0.25% (95%CI: 0.16%-0.33%) of adults in China had cardiovascular health score of 100, and 33.0% (95%CI: 31.6%-34.3%), 63.2% (95%CI: 62.1%-64.3%), and 3.9% (95%CI: 3.5%-4.2%) of adults had high, moderate and low cardiovascular health scores, respectively. The proportion of those with high cardiovascular health scores was relatively low in men, those with low education level, those with low income, those living in rural areas, and those living in southwest China (P<0.001). Of the eight factors, diet had the lowest mean score (46.0, 95%CI: 44.7-47.3), followed by blood pressure (59.4, 95%CI: 58.2-60.6) and tobacco exposure (61.4, 95%CI: 60.6-62.2). Conclusions: The cardiovascular health status of two-thirds of adult population in China needs to be improved. Diet, tobacco exposure, and blood pressure are the factors affecting the cardiovascular health of Chinese population, to which close attention needs to be paid, and men, rural residents, and those with lower socioeconomic status are key groups in cardiovascular health promotion.

Assessment of Old Age behaviors toward Cardiovascular Health Promotion

        Abstract:&#x0D; Objective: To assess old age behaviors toward cardiovascular health promotion. Find out the association between old age behaviors toward cardiovascular health promotion with certain sociodemographic characteristic and type of geriatric home.&#x0D; Methodology:  A descriptive study is conducted throughout the period of (April 12th 2022 to august 22nd, 2023) presented to assess of old age behaviors toward cardiovascular health promotion. Purposive sample of (140) old age were selected from males and female’s participants from public and private Geriatric Homes at Baghdad city questionnaire validity the instrument was presented to 16 experts in various fields of nursing to make it more valid. The internal consist reliability determine by Cronbach Alpha correlation which was r=0.93 for behaviors of health promotion.&#x0D; Results: Indicates that There is a difference in elderly health promotion behaviors among those in public and private homes and that is because of the levels of health care services and health supervision in these geriatric homes. Demographic data and general health statues among elderly in geriatric homes present an impact upon their behaviors toward CVD health promotion and there is significant difference between them according to their demographic data and health statues, type of home, of age, gender, monthly income, level of education, chronic disease).&#x0D; Conclusion: Concluded that the majority of studied elderly is practicing moderate behavior regarding CVD health promotion.&#x0D; Recommendation: Carrying out other studies on and healthy lifestyles behaviors for elderly who have low education level. Create a curriculum for small group counselling that will educate elderly about the importance of a healthy behaviors and positive attitude and relationship with having CVD.&#x0D; Key words- Assessment, Behavior, cardiovascular health promotion&#x0D;