Ideal Cardiovascular Health Components Research Articles

The association between parental cardiovascular health status and the risk of obesity in their offspring: Tehran Lipid and Glucose Study

Background and aimsLittle is known about the association of parental cardiovascular risk factors with the risk of obesity in offspring. We aimed to investigate whether parental ideal cardiovascular health (ICVH) status was associated with the risk of general and central obesity in their young/adult offspring. Methods and resultsOf individuals who participated in the 2012-15 phase of the Tehran Lipid and Glucose Study, 2395 pairs of parent-unmarried offspring aged ≥6 years were selected in this cross-sectional study. General and central obesity were defined based on Iranian BMI percentile reference data for offspring aged ≤18 years. For subjects aged ≥19 years, central obesity was defined based on the introduced cut-off points for Iranian adults. We employed the American Heart Association's 2020 impact goal criteria of ICVH.The mean ± SD age of fathers and mothers were respectively 55.4 ± 9.79 and 48.4 ± 9.88. About 55% of offspring were older than 19 years. Higher adherence to ICVH score in mothers was associated with lower risk of overweight/obesity in female offspring (OR for Q1-Q4: 1, 0.56, 0.57, 0.37, P < 0.05 for all quartiles). Among ICVH components, only ideal BMI status in fathers was observed to be associated with a lower risk of overweight/obesity in their male offspring. The risk of abdominal obesity decreased in female offspring with increasing total ICVH score in mothers. ConclusionHigher adherence of parents to ICVH and its components was positively associated with a lower risk of general and abdominal obesity in their offspring. Our findings demonstrate that maternal-offspring relationship was stronger than paternal-offspring association.

Abstract 52: Associations of Ideal Cardiovascular Health and Its Change With Cardiovascular-Kidney Outcomes in Young Adults

Introduction: The AHA recently highlighted the linkage of cardiovascular (CVD) and chronic kidney disease (CKD) and the importance of promoting cardiovascular health (CVH) to prevent them. We hypothesized that attaining ideal CVH score or improving it in young adulthood is associated with low risk of cardiovascular-kidney events, but data are scarce. Methods: We studied 3,836,283 participants of the Korean national health screening in 2009-2010 (baseline age 20-39 y) without prior CVD or CKD. Participants were categorized by the number of ideal CVH components met (range 0-6; diet data unavailable). A subgroup of 2,768,705 participants who underwent follow-up health exam in 2011-2014 (median 4.2 y from baseline) were stratified by combination of baseline and follow-up CVH scores. The primary outcome was a composite of CVD events, incident CKD, and death from kidney disease or CVD, until 31 Dec 2021 (Fig, footnote). Results: At baseline, participants had median age 31 y, and 38.2% were female. During a median follow-up of 12.1 y, 172,217 cardiovascular-kidney events occurred. The multivariable-adjusted risk of cardiovascular-kidney event decreased gradually (HR 0.81 per 1 p higher CVH score) with higher CVH scores (Fig, A). A CVH score of 6 was associated with a 65% lower risk of cardiovascular-kidney event than a CVH score of 0. An increase in CVH score from the baseline to follow-up exam was associated with a lower risk of cardiovascular-kidney event (HR 0.87 per +1 p CVH score change). The risk was lowest in participants with high CVH at both baseline and follow-up; having high CVH at baseline, and improving from low to high CVH, were also associated with lower risk than those who maintained low CVH (Fig, B). Findings were similar for CKD and other individual endpoints. Conclusions: Achieving, maintaining, or improving ideal CVH during young adulthood was associated with lower risk of cardiovascular-kidney events, highlighting the importance of promoting early-life CVH for combined prevention of cardiovascular and kidney disease.

Koncept i značaj idealnog kardiovaskularnog zdravlja

Cardiovascular diseases (CVD) are the leading cause of death worldwide. In 2019, 17.9 million people died from CVD which accounts for 32% of all deaths globally. The burden of CVD in a given population is related to the cardiovascular health (CVH) of that particular population. In 2010, The American Heart Association initiated a new concept of ideal CVH focused on two groups, health behavior components (smoking, body mass index, physical activity, and diet) and health components (total cholesterol, blood glucose, and blood pressure). Ideal CVH is defined as the simultaneous presence of seven ideal CVH components or "Life's Simple 7" (non-smoking, body mass index &lt;25 kg/m2 , level of physical activity up to the achievement of the set goal, diet in accordance with national recommendations, blood pressure &lt;120/80 mm Hg, total cholesterol &lt;200 mg/dL and blood glucose level &lt;100 mg/dL) in the absence of clinically manifested CVD. The prevalence of ideal CVH is low worldwide and is less than 1% in the USA, China and Spain, and the lowest values (0.02% and 0,1%) were recorded in the Republic of Srpska, Bosnia and Herzegovina and Serbia, respectively. The ideal CVH is inversely related to the incidence and mortality rates of CVD, as well as the overall mortality rates. People with a greater number of ideal CVH metrics (5, 6, and 7) are significantly less likely to suffer from CVD, ischemic heart disease and stroke, and have lower mortality from CVD, as well as lower total mortality compared to people without any or with only one ideal component of CVH. The status of CVH in the population is essential for predicting the risk of morbidity and mortality from CVD, which can be reduced by improving both health/biological and behavioral components of CVH.

Associations between cumulative social risk, psychosocial risk, and ideal cardiovascular health: Insights from the HeartSCORE study

BackgroundLimited studies have assessed the effects of psychosocial risk factors on achievement of ideal cardiovascular health (CVH). MethodsUsing the Heart Strategies Concentrating on Risk Evaluation (HeartSCORE) cohort, we examined the cross-sectional associations of cumulative social risk (CSR) and three psychosocial factors (depression, stress, perceived discrimination) with ideal CVH. CSR was calculated by assigning one point for each of: low family income, low education level, minority race (Black), and single-living status. Ideal CVH was calculated by assigning one point for ideal levels of each factor in American Heart Association's Life's Simple 7. Ideal CVH was dichotomized into fewer versus higher by combining participants achieving <3 versus ≥3 factors. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of having fewer ideal CVH factors. Psychosocial factors were assessed as mediators of the association between CSR and ideal CVH. ResultsWe included 2000 participants (mean age 59.1 [7.5] years, 34.6% male, 42.7% Black, and 29.1% with low income), among whom 60.6% had <3 ideal CVH factors. The odds of having fewer ideal CVH factors increased significantly with increasing CSR scores from 1 to 2, to ≥3 compared to individuals with CSR score of zero, after adjusting for age and sex (OR [95% CIs]: 1.77 [1.41 - 2.22]; 2.09 [1.62 - 2.69] 2.67 [1.97 - 3.62], respectively). Taking the components of ideal CVH separately, higher CSR was directly associated with odds of being in ‘non-ideal’ category for six of the seven factors, but was inversely associated with probability of being in ‘non-ideal’ category for cholesterol. The association was modestly attenuated after adjusting for depression, stress, and perceived discrimination (corresponding OR [95% CI]: 1.69 [1.34 - 2.12], 1.96 [1.51 - 2.55], 2.34 [1.71 - 3.20]). The psychosocial factors appeared to mediate between 10% and 20% of relationship between CSR and ideal CVH. ConclusionsIncreased CSR was associated with lower probability of achieving ideal CVH factors. A modest amount of the effect of CSR on ideal CVH appeared to be mediated by depression, stress and perceived discrimination. Public health strategies aimed at improving ideal cardiovascular health may benefit from including interventions targeting social and psychosocial risk factors.

Sex Differences in Temporal Trends of Cardiovascular Health in Young US Adults.

BackgroundFavorable cardiovascular health (CVH) in young adulthood has been associated with lower future cardiovascular risk. We determined whether CVH and its sex differences in young adults have changed from 2007 to 2018.Methods and ResultsWe identified 10 206 individuals, aged 20 to 39 years, from the National Health Examination and Nutrition Survey data. CVH was assessed on the basis of the American Heart Association’s Life’s Simple 7 metrics (of 7). Changes in the mean number of ideal CVH components and the ideal proportion of individual components were calculated using linear regression analysis. Changes in sex difference trends were assessed with an interaction term between sex and calendar year. The mean (SD) age of the study population was 29.3 (5.8) years, and 5260 (51.5%) individuals were women. The mean (SD) ideal CVH component remained unchanged for both women (4.40 [1.22] to 4.48 [1.15]; P=0.94) and men (3.97 [1.27] to 3.93 [1.24]; P=0.87), with stable sex differences (P for interaction=0.94). Nonetheless, sex differences in blood pressure widened as ideal blood pressure decreased in men (54.0% to 46.9%; P=0.03) but not in women (P for interaction <0.001). Concurrently, the proportion with ideal physical activity declined in women (57.3% to 49.4%; P=0.04) but remained stable in men (P for interaction=0.03). Nonsmoking increased to a greater extent in women (64.1% to 70.5%; P=0.05) than in men (P for interaction=0.01).ConclusionsSex disparities in CVH have persisted with exacerbated differences in blood pressure, physical activity, and smoking. These insights provide opportunities to promote equitable CVH.

Abstract MP38: Gender Differences In Temporal Trends Of Cardiovascular Health In Young US Adults

Introduction: Favorable cardiovascular health (CVH) in young adulthood has been associated with lower future cardiovascular risk. Characterizing the gender-stratified temporal trends of CVH among younger adults may better inform opportunities for earlier prevention. Therefore, we assessed persistence of gender differences in overall CVH and individual component in young US adults. Methods: Based on the National Health Examination and Nutrition Survey data 2007-2018, we identified 10,206 individuals aged 20 to 39 years. Gender and sociodemographic measures were self-reported. The CVH was assessed based on the American Heart Association’s Life’s Simple 7 metrics. Changes in the mean number of ideal CVH components (out of 7) and the ideal proportion of individual component were calculated using weighted linear regression analysis. Changes in gender differences were assessed with an interaction term between gender and calendar year. Results: The mean [SD] age of the study population was 29.3 [5.8] years, and 5,260 (51.5%) individuals were female. Between 2007 and 2018, the mean [95% CI] ideal CVH component remained unchanged in both females (4.40 [4.27-4.52] to 4.48 [4.34-4.61]; P value=0.94) and males (3.97 [3.86-4.08] to 3.93 [3.76-4.10]; P value=0.87) with stable gender differences ( P for interaction=0.94). Nonetheless, gender differences in blood pressure widened ( P for interaction &lt;0.001) as ideal blood pressure decreased (54.0% to 46.9%; P value=0.03) only in males. Concurrently, the proportion of females with ideal physical activity level declined (57.3% to 49.4; P value=0.04) whereas stagnant in males ( P for interaction=0.03). Non-smoking increased in females (64.1% to 70.5%; P value=0.05), otherwise unchanged in males ( P for interaction=0.01). Conclusions: Gender disparities in CVH have persisted with exacerbated differences in blood pressure, physical activity, and smoking. These insights provide opportunities to promote equitable CVH and to address disparities.

Sex- and Age-Specific Trends in Cardiovascular Health in Korea, 2007-2018.

We illustrated sex- and age-specific temporal trends in cardiovascular health among Korean adults. From the Korean National Health and Nutrition Examination Survey 2007-2018, we included 61,408 participants aged 20 years or older. The ideal levels of 6 components of cardiovascular health metrics were defined as never-smoking, ≥75 min/week of vigorous or ≥150 min/week of moderate-to-vigorous physical activity, body mass index (BMI) <23 kg/m², total cholesterol <200 mg/dL, blood pressure (BP) <120/80 mmHg, and fasting glucose <100 mg/dL. Temporal trends in the number of ideal cardiovascular health components and distribution of each component were assessed by sex and age. The average number of ideal cardiovascular health components decreased from 3.37 in 2007-2009 to 2.86 in 2016-2018. Never smoking increased from 56.0% to 59.2%, largely contributed by young men. Ideal physical activity halved (41.4-21.3%); such decline was more pronounced in women and with older age. Ideal BMI decreased from 44.3% to 42.2%, more apparently in young and elderly men. In contrast, ideal BMI increased in middle-aged and elderly women. Ideal cholesterol decreased from 65.5% to 50.3%, profoundly in young adults and relatively greater in men. Ideal BP declined from 55.1% to 46.9%, more evidently in men. However, ideal BP discernibly increased in middle-aged women. Ideal glucose decreased from 74.6% to 66.0%, comparatively greater and earlier in men. The proportion of Korean adults with ideal cardiovascular health decreased between 2007 and 2018, but the course of responsible factors differed across sex and age groups.

Ideal Cardiovascular Health Is Associated With Slowness Among Community-Dwelling Older Adults

Slowness is associated with increased disability and mortality in older people. However, the relation between ideal cardiovascular health (CVH) and slowness in community-dwelling older adults is uncertain. We examined the prevalence of ideal CVH in Korean older adults and its association with slowness in community-dwelling older adults. We analyzed 2,597 participants (mean age 76.0±3.9 years, 54.4% women) without cardiovascular disease from the Korean Frailty and Aging Cohort Study. The usual gait speed over a distance of 4 m was measured using an automatic timer, and slowness was defined as a speed <1.0 m/s. Ideal CVH was described as attainment of ideal health behaviors (no smoking, regular physical activity, ideal body mass index, and healthy diet) and optimal health factors (blood pressure, HDL-cholesterol, and glycated hemoglobin). Multiple logistic regression analysis was used to examine the association between the CVH score and slowness. Ideal CVH was present in 785(30.2%) subjects. Considering those with poor level of CVH were as the reference group, the odds ratios [OR] for slowness were 0.55 (95% confidence interval [CI], 0.39-0.77) for those with intermediate level of CVH, and 0.28 (95% CI, 0.17-0.45) for those with ideal level of CVH after adjustment for potential confounders. Among ideal CVH components, behavioral CVH score (OR 0.65, 95% CI 0.58-0.74) was significantly associated with slowness vs. the biological CVH score (OR 0.95, 95% CI 0.84-1.07). This study indicates that ideal CVH is significantly associated with a lower risk of slowness in community-dwelling older adults. A better CVH may help prevent slowness.

Association Between Sleep Duration and Ideal Cardiovascular Health Among US Adults, National Health and Nutrition Examination Survey, 2013-2016.

IntroductionShort or long sleep duration is a risk factor for cardiovascular disease, but the association between sleep duration and cardiovascular health is unclear. Our objective was to quantify the association between sleep duration and ideal cardiovascular health (CVH) in US adults. We hypothesized that very short (<6 h) and very long (≥9 h) sleep duration were associated with poorer CVH compared with sleep lasting 7 to <8 hours.MethodsWe conducted a cross-sectional evaluation of the nationally representative National Health and Nutrition Examination Survey in 2 cycles (2013–2014 and 2015–2016). Participants were 7,784 cardiovascular disease–free US adults aged 20 to 75. Self-reported sleep duration was categorized as <6 hours, 6 to <7 hours, 7 to <8 hours, 8 to <9 hours, and ≥9 hours. The American Heart Association’s ideal CVH metrics were used to determine the number of ideal CVH components, dichotomized as ideal (5–7 components) or not ideal (0–4 components). Survey-weighted logistic and linear regression models were used to determine the association between sleep duration and ideal CVH.ResultsThe weighted prevalences of those who slept 7 to <8 hours were 30.4%, very short sleep duration (<6 h), 9.0%, and very long duration (≥9 h), 13.5%. Only 21.3% of the population had ideal CVH. Compared with 7 to <8 hours, very short duration (OR = 0.65; 95% confidence interval [CI], 0.47–0.90) and very long duration (OR = 0.72; 95% CI, 0.55–0.94) were associated with decreased odds of ideal CVH. We confirmed findings by using linear regression.ConclusionsVery short and very long sleep duration were associated with decreased odds of ideal CVH and lower mean CVH scores. Future research should focus on clarifying causal associations between sleep duration and ideal CVH.

Ideal cardiovascular health metrics and the risk of non‐alcoholic fatty liver disease: A cross‐sectional study in northern China

The components of ideal cardiovascular health (CVH) metrics have been shown to be associated with non-alcoholic fatty liver disease (NAFLD). The present study aimed to determine the association between ideal CVH metrics and NAFLD. A total of 10,511 participants (47.26% men) aged 18 to 92years were selected from the Jidong and Kailuan communities. Ideal CVH was based on 7 ideal CVH metrics: smoking, body mass index (BMI), physical activity, diet, total cholesterol, blood pressure and fasting blood glucose. NAFLD was determined by abdominal ultrasonography. All participants underwent questionnaire assessments and clinical and laboratory examinations. Logistic regression models were used to analyse the relationship of CVH metrics and the number of ideal CVH metrics with NAFLD. The prevalence rates of NAFLD by CVH summary score quartiles were 64.38% (2,015/3,130), 50.16% (786/1,567), 33.28% (1,194/3,588) and 20.89% (465/2,226). Participants in the highest quartile showed a lower odds ratio (OR) than those in the lowest quartile (fully adjusted OR: 0.17, 95% CI: 0.17-0.20, P<0.001). Similar results were observed in subjects stratified by sex and age (45years). The ORs were progressively decreased with an increased number of ideal CVH metrics (all P<0.001). NAFLD was significantly associated with both the summary score of CVH metrics and the number of ideal CVH metrics. The combined evaluation of ideal CVH may contribute to the prevention of NAFLD.

Ideal cardiovascular health, glycaemic status and incident type 2 diabetes mellitus: the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.

Ideal cardiovascular health (CVH) is associated with lower diabetes risk. However, it is unclear whether this association is similar across glycaemic levels (normal [<5.6mmol/l] vs impaired fasting glucose [IFG] [5.6-6.9mmol/l]). A secondary data analysis was performed in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Incident diabetes was assessed among 7758 participants without diabetes at baseline (2003-2007) followed over 9.5years. Baseline cholesterol, blood pressure, diet, smoking, physical activity and BMI were used to categorise participants based on the number (0-1, 2-3 and ≥4) of ideal CVH components. Risk ratios (RRs) were calculated using modified Poisson regression, adjusting for cardiovascular risk factors. Among participants (mean age 63.0 [SD 8.4] years, 56% female, 73% white, 27% African-American), there were 891 incident diabetes cases. Participants with ≥4 vs 0-1 ideal CVH components with normal fasting glucose (n = 6004) had 80% lower risk (RR 0.20; 95% CI 0.10, 0.37), while participants with baseline IFG (n = 1754) had 13% lower risk (RR 0.87; 95% CI 0.58, 1.30) (p for interaction by baseline glucose status <0.0001). Additionally, the magnitude of the association of ideal CVH components with lower diabetes risk was stronger among white than African-American participants (p for interaction = 0.0338). A higher number of ideal CVH components was associated with a dose-dependent lower risk of diabetes for participants with normal fasting glucose but not IFG. Tailored efforts that take into account observed differences by race and glycaemic level are needed for the primordial prevention of diabetes.

Length of Residence and Cardiovascular Health among Afro-Caribbean Immigrants in New York City.

Cardiovascular disease (CVD) disproportionately affects non-Hispanic blacks (NHB) in the United States (U.S.). Afro-Caribbean (AC) immigrants comprise over 50% of the immigrant black population and are critical in understanding the health trajectories of blacks in the U.S. We assessed the relationship between length of residence (proxy measure for acculturation) and cardiovascular health (CVH) based on the American Heart Association's (AHA) seven ideal cardiovascular health components among AC immigrants in New York City (NYC). CVH scores were categorized into poor/intermediate CVH (0-3 components) or ideal CVH (≥ 4 components). Multivariable logistic regression was used to examine the association between length of residence in the U.S. and poor/intermediate CVH. In adjusted models, the odds of poor/intermediate CVH were significantly higher for Guyanese (OR = 3.51; 95% CI 1.03-11.95) and Haitian immigrants (OR = 8.02; 95% CI 1.88-34.12) residing in the U.S. for ≥ 10years than for those living in the U.S. for < 10years. Length of residence was not significantly associated with CVH among Jamaican immigrants. We found evidence of ethnic differences in the association between acculturation and CVH among AC immigrants in a major metropolitan city. Culturally tailored interventions are needed to improve the CVH of AC immigrants as they become integrated into the U.S., with special consideration of country of birth.

Abstract 11315: Ideal Cardiovascular Health, Cardiometabolic Remodeling, and Heart Failure in African-Americans: The Jackson Heart Study

Background: Though African-Americans are at disproportionately high risk for heart failure (HF) and cardiometabolic disease, few studies have evaluated the association between ideal cardiovascular health metrics and cardiometabolic diseases or incident HF in African-Americans. Hypothesis: Ideal cardiovascular health is associated with adverse cardiometabolic phenotypes and incident HF. Methods: A total of 4195 African-American participants without prevalent coronary heart disease with 7 ideal cardiovascular health (ICVH) metrics measured at baseline (2000-2004) underwent evaluation by cardiac magnetic resonance (CMR; n=1188) and/or abdominal computed tomography (CT; n=2352). 3661 (87%) participants were followed for incident HF. Results: Mean age at baseline was 54.4 years (65% women). A lower composite score of ICVH at baseline was associated with greater LV hypertrophy, greater LV concentric remodeling, worse LV strain, and greater visceral and subcutaneous adipose tissue in follow-up (all P &lt;0.0001). Ideal BMI, absence of smoking, controlled blood pressure and normoglycemia were associated with improved cardiac and adiposity phenotypes. Relative to individuals with 0-2 ideal ICVH factors, African-Americans with 3 factors had 48% lower incident HF risk (HR 0.52, 95% CI 0.35-0.75, P=0.0006) and those with ≥ 4 factors had 58% lower HF risk (HR 0.42, 95% CI 0.24-0.76, P=0.004). Of the 7 components of ICVH, non-ideal physical activity, smoking, and impaired glucose control were associated with incident HF risk. Conclusions: In African-Americans, lower ideal cardiovascular health in mid-life is associated with later adverse cardiometabolic remodeling and incident HF. Lack of physical activity, smoking and impaired glucose control are associated with incident HF risk and represent potential targets for prevention of cardiometabolic disease and HF in African-Americans.

Association of ideal cardiovascular health metrics and cognitive functioning: the APAC study.

Previous studies have demonstrated that the components of ideal cardiovascular health (CVH) metrics are related to dementia. This study aimed to investigate the overall effects of ideal CVH metrics on cognitive functioning. Information was collected on the seven ideal CVH metrics (smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol and fasting blood glucose) from the Asymptomatic Polyvascular Abnormalities Community study, and cognitive functioning was assessed by the score of the Mini-Mental State Examination (MMSE). Multivariate logistic regression and linear regression models were used to assess the relationships between ideal CVH metrics and cognitive functioning. A total of 3260 (56.7% men) patients were included in this study. After adjusting for potential confounding factors, the associations between the number or score of ideal CVH metrics and cognitive impairment remained significant [odds ratio (OR) (95% confidence interval) 0.773 (0.664-0.928) and 0.904 (0.831-0.983), respectively]. In addition, there were significant linear relationships between the number or score of CVH metrics and the score of the MMSE (β = 0.211 and 0.134 respectively, P < 0.001). A clear inverse association was observed between the number or score of ideal CVH metrics and cognitive impairment in a Chinese population, supporting the importance of ideal CVH metrics in prevention of dementia.

Socio-Economic Differences in Cardiovascular Health: Findings from a Cross-Sectional Study in a Middle-Income Country.

BackgroundA relatively consistent body of literature, mainly from high-income countries, supports an inverse association between socio-economic status (SES) and risk of cardiovascular disease (CVD). Data from low- and middle-income countries are scarce. This study explores SES differences in cardiovascular health (CVH) in the Republic of Srpska (RS), Bosnia and Herzegovina, a middle-income country.MethodsWe collected information on SES (education, employment status and household’s relative economic status, i.e. household wealth) and the 7 ideal CVH components (smoking status, body mass index, physical activity, diet, blood pressure, total cholesterol, and fasting blood glucose) among 3601 participants 25 years of age and older, from the 2010 National Health Survey in the RS. Based on the sum of all 7 CVH components an overall CVH score (CVHS) was calculated ranging from 0 (all CVH components at poor levels) to 14 (all CVH components at ideal levels). To assess the differences between groups the chi-square test, t-test and ANOVA were used where appropriate. The association between SES and CVHS was analysed with multivariate linear regression analyses. The dependent variable was CVHS, while independent variables were educational level, employment status and wealth index.ResultsAccording to multiple linear regression analysis CVHS was independently associated with education attainment and employment status. Participants with higher educational attainment and those economically active had higher CVHS (b = 0.57; CI = 0.29–0.85 and b = 0.27; CI = 0.10–0.44 respectively) after adjustment for sex, age group, type of settlement, and marital status. We failed to find any statistically significant difference between the wealth index and CVHS.ConclusionThis study presents the novel information, since CVHS generated from the individual CVH components was not compared by socio-economic status till now. Our finding that the higher overall CVHS was independently associated with a higher education attainment and those economically active supports the importance of reducing socio-economic inequalities in CVH in RS.

Association of Ideal Cardiovascular Health and Long-term Healthcare Costs.

The American Heart Association's (AHA's) 2020 Strategic Impact Goals introduced the concept of ideal cardiovascular (CV) health based on seven health factors and behaviors associated with lower CV disease (CVD) risk. The association between CV health and healthcare costs has not been reported; therefore, we evaluated the association between CV health profile and later-life healthcare costs. Cooper Center Longitudinal Study participants (N=4,906; mean age, 56 years) receiving Medicare coverage from 1999 to 2009 were included. CV health behaviors (diet, physical activity, BMI, smoking) and CV health factors (blood pressure, total cholesterol, blood glucose) were categorized as unfavorable (zero to two ideal components); intermediate (two to four); and favorable (five to seven). Healthcare costs were cumulated from Medicare claims data, adjusted for inflation. Associations between midlife CV health status and non-CVD and CVD-related costs were estimated using multivariable quantile regression. Analyses were conducted in 2013 and 2014. Favorable CV health was prevalent in 14.8% of men and 30.1% of women, with <1% having ideal levels of all health metrics. After 31,945 person-years of Medicare follow-up, individuals with favorable CV health exhibited 24.9% (95% CI=11.7%, 36.0%) lower median annual non-CVD costs and 74.5% (57.5%, 84.7%) lower median CVD costs than those with unfavorable CV health. Annualized differences were greater for non-CVD costs than for CVD costs ($1,175 vs $566). Having more ideal CV health components in middle age, as outlined by the AHA 2020 Goals, is associated with lower non-CVD and CVD healthcare costs in later life.

Cardiorespiratory fitness and ideal cardiovascular health in European adolescents

ObjectiveWe studied in European adolescents (i) the association between cardiorespiratory fitness and ideal cardiovascular health as defined by the American Heart Association and (ii) whether there is a cardiorespiratory fitness...

0064 Levels of ideal, intermediate and poor cardiovascular health by employment characteristics in 2005–06 National Health and Nutrition Examination Survey

ObjectivesEmployed persons are considered healthier than the general population. Yet, between 5–18% of all coronary heart disease deaths can be attributed to occupational exposures, ranging from noise to job stress....

The Impact of Hispanic Ethnicity on Knowledge and Behavior Among Patients With Diabetes

The purpose of the study was to measure the current level of awareness of the American Heart Association's 7 risk/protective factors of cardiovascular health among adults with diabetes of Hispanic and non-Hispanic origin and to identify factors associated with knowledge deficits. A cross-sectional survey measured demographic data, personal behaviors/health factors, cardiovascular disease (CVD) history, and knowledge of 7 components of ideal cardiovascular health (smoking, obesity, exercise, diet, cholesterol, blood pressure, and blood glucose). A subset of 331 Hispanic and white patients with diabetes was surveyed. Knowledge scores were dichotomized between full knowledge (7 components) and less than full knowledge and compared between ethnicities using multiple logistic regression. Seventy-nine percent of surveys were returned; 50.5% of subjects were Hispanic. Median age was 64.5 years with 60.7% being female. Two-thirds of the sample completed high school and 26% reported comorbid CVD. Recognition of diabetes as a risk factor didn't differ by ethnicity. Thirty-five percent of respondents identified 7 American Heart Association risk factors. Hispanics were less likely to identify 7 components. After adjustment for education and English literacy, the difference disappeared. Better knowledge was positively associated with healthier behaviors for high cholesterol, hypertension, and exercise only among white patients. Hispanic patients with diabetes exhibit less knowledge about CVD risk/protective factors due to lower education and English literacy. Educational interventions should be tailored to those with less education/limited English proficiency.

Effect of Patients’ Awareness of CVD Risk Factors on Health-Related Behaviors

In 2010, the American Heart Association unveiled a strategic plan to reduce cardiovascular deaths by targeting seven components of ideal cardiovascular health. Although education is a sensible first step, it is not known whether awareness correlates with healthy behavior. The objective of the study was to examine the association between awareness of risk factors and ideal cardiovascular health behavior. We surveyed patients 40 years and older at five ambulatory clinics. The survey measured demographics, health management behaviors, comorbidities, and awareness of five modifiable cardiac risk factors (smoking, obesity, high cholesterol, hypertension and diabetes mellitus) and one protective factor (exercise). Healthy behavior was defined as follows: diabetes, hemoglobin A1c <8.0%; hypertension, systolic blood pressure <140 mm Hg), high cholesterol, medication adherence; obesity, attempting to lose weight; smoking, abstinence; and exercise, ≥ 30 minutes/day, ≥ 3 times per week. For five modifiable risk factors, awareness was positively associated with healthy behavior in multivariable models: obesity, hypertension, exercise, cholesterol, and diabetes. Awareness was inversely associated with smoking abstention. Awareness that a specific factor increases the risk for cardiovascular disease was positively associated with healthy behavior regarding most risk factors; however, the association was modest, suggesting that awareness alone does not motivate behavior.