Ideal Health Metrics Research Articles

The Role of Social Determinants in Alcohol Consumption and Cardiovascular Health: The Pathways Study

Background and AimsThe "J"-shaped relationship between alcohol consumption and cardiovascular health is recognized as potentially influenced by residual confounders, and this study aimed to clarify the role that social determinants play in the relationship. Methods and ResultsUsing NHANES data from 2005-2018, this study analyzed 30,648 participants to assess how eight social determinants (employment, income, food security, education, healthcare access, insurance, housing stability, and marital status) influence the relationship between alcohol consumption and cardiovascular disease (CVD). Moderate drinking reduces CVD risk (HR: 0.741, 95%CI: 0.661, 0.831, P<0.001), while heavy drinking increases it (HR: 1.025, 95%CI: 1.004, 1.095, P=0.035). Structural equation modeling revealed that ideal social determinants and health metrics contribute significantly to the cardiovascular protective effects of moderate drinking (path proportion: 42.31%). Conversely, heavy drinking is associated with poorer social determinants and health metrics, masking the cardiovascular protective effect (path proportion: -90.91%). ConclusionsThis study quantifies the role of social and health factors in the relationship between alcohol consumption and CVD. Despite identifying direct cardiovascular protective effects of alcohol consumption, global health initiatives should continue to advocate for reduced heavy drinking, given the significant risks involved.

Prevalence of cardiometabolic risk and health factors among Puerto Rican young adults in the Boricua Youth Study – Health Assessment

We describe and compare the prevalence of cardiometabolic risk factors and ideal cardiovascular health (CVH) among Puerto Rican young adults in the San Juan metro area in Puerto Rico and the South Bronx, NY. As part of the Boricua Youth Study – Health Assessment, (mean age 23±0.1 years) objective anthropometric, blood pressure and blood samples were collected. Information on diet, physical activity and sleep were collected via surveys. Life’s Essential 8 metrics were characterized as continuous with higher scores indicating more optimal CVH and categorically (80-100 scores for ideal CVH). Mean CVH score among NY participants was lower (61.9) than in PR (68.9). No participant had all ideal health metrics, 36% of participants in PR had 5 or more ideal CVH; while only 16% in NY met this criterion. The prevalence of cardiometabolic risk factors was high for obesity (35% in NY, 19% in PR) and diabetes (17% NY, 20% PR). In this ethnically homogenous population, we found low levels of ideal CVH that varied across study site, suggesting differences by sociocultural context. Interventions to maintain and improve CVH across the life course, tailored to sociocultural environments, are necessary for the prevention of cardiovascular disease.

Mobile-phone text messaging to promote ideal cardiovascular health in women

ObjectiveIdeal cardiovascular health (CVH) was developed to promote CVH as a key component of primordial prevention. Mobile short message service (SMS) is useful for improving health behaviours. We aim to...

Lipidomic Profiling Identifies Signatures of Poor Cardiovascular Health.

Ideal cardiovascular health (CVH) is defined for the presence of ideal behavioral and health metrics known to prevent cardiovascular disease (CVD). The association of circulatory phospho- and sphingo-lipids to primary reduction in cardiovascular risk is unclear. Our aim was to determine the association of CVH metrics with the circulating lipid profile of a population-based cohort. Serum sphingolipid and phospholipid species were extracted from 461 patients of the randomly selected prospective Kardiovize study based on Brno, Czech Republic. Lipids species were measured by a hyphenated mass spectrometry technique, and were associated with poor CVH scores, as defined by the American Heart Association. Phosphatidylcholine (PC), phosphatidylethanolamine (PE), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE) species were significantly lower in ideal and intermediate scores of health dietary metric, blood pressure, total cholesterol and blood fasting glucose compared to poor scores. Current smokers presented higher levels of PC, PE and LPE individual species compared to non-smokers. Ceramide (Cer) d18:1/14:0 was altered in poor blood pressure, total cholesterol and fasting blood glucose metrics. Poor cardiovascular health metric is associated with a specific phospho- and sphingolipid pattern. Circulatory lipid profiling is a potential biomarker to refine cardiovascular health status in primary prevention strategies.

Correlation Between Ideal Cardiovascular Health Metrics and Plasma hs-CRP Levels in a North China Population: One Four-Year Follow-Up Study.

BackgroundThis prospective cohort study aimed to evaluate the potential association of ideal cardiovascular health metrics with the plasma levels of highly sensitive C-reactive protein (hs-CRP) among people in North China.MethodsA total of 80,968 participants were included in this study at baseline. Data relating to seven health metrics and plasma hs-CRP levels were collected at baseline and the end of follow-up. The change in health metrics of each individual was compared and recorded. The potential association of gain or loss of each health metric, as well as the change in the total number of health metrics that each individual had during follow-up, with the risk of increased hs-CRP level, were explored by multiple Cox proportional hazards models.ResultsA total of 72,321 participants (94.51%) completed the follow-up, and the average follow-up time was 4.1 years. Ideal body mass index (BMI), physical activity, smoking status and total cholesterol all had significant impacts on hs-CRP levels, with ideal BMI having the largest impact. Losing ideal BMI during follow-up raised the probability of hs-CRP increase during the follow-up time by 1.72 (95% CI, 1.59–1.86) times for men and 2.05 (95% CI, 1.76–2.39) times for women. The effects of ideal salt intake and blood pressure on hs-CRP levels were uncertain. Changes in the total number of ideal metrics for each individual had a significant cumulative effect on hs-CRP. The hazard ratio of loss of four to six health metrics during follow-up on the risk of hs-CRP increase was 1.69 (95% CI, 1.38–2.06) for men and 1.52 (95% CI, 1.13–2.04) for women.ConclusionLoss or gain of ideal cardiovascular health metrics is associated with significant fluctuations in plasma hs-CRP levels. The cardiovascular benefits brought by the ideal health metrics are mediated at least in part by reducing systemic inflammation in the body.

The Tyrolean early vascular ageing-study (EVA-Tyrol): study protocol for a non-randomized controlled trial

BackgroundAccording to the World Health Organization, cardiovascular diseases (CVDs) are the leading non-communicable cause of death. Awareness of the individual risk profile is crucial to implement a healthy lifestyle and prevent CVDs. Multiple studies demonstrated that atherosclerosis, the main cause of CVDs, begins early in life. Therefore, it may be necessary to start prevention programs already in childhood.MethodsThe EVA-Tyrol study is a population-based non-randomized controlled trial that will prospectively enroll 2000 participants from high schools and training companies in North- and East-Tyrol (Austria) and South-Tyrol (Italy). Participants will be assigned to either an intervention (n = 1500) or a control (n = 500) group. Intervention group participants will be enrolled at the 10th school grade (mean age 15–16 years), undergo two examinations within a two-year interval, with follow-up at the 12th grade (mean ages 17–18 years). Control group participants will be enrolled at the 12th grade (mean age 17–18 years). Medical examination will include anthropometric measurements, comprehensive lifestyle and dietary questionnaires, a fasting blood sample, high-resolution ultrasound of the carotid arteries, and measurement of carotid-femoral pulse wave velocity. Active intervention will consist of (1) enhancing knowledge about CVDs, (2) individual medical counseling based on the results of the baseline examination, (3) an online health promotion tool and (4) involvement of participants in planning and implementation of health promotion projects. Effectiveness of the intervention will be assessed by comparing the proportion subjects with ideal health metrics as defined by the American Heart Association between study groups.DiscussionThis study aims to improve cardiovascular health in Tyrolean adolescents by demonstrating the efficacy of a multi-layer health promotion program and may yield novel insights into the prevalence of vascular risk conditions and mechanisms of early vascular pathologies in adolescents.Trial registrationEVA-Tyrol has been retrospectively registered at clinicaltrials.gov under NCT03929692 since April 29, 2019.

The impact of modifiable risk factors on the long-term outcomes of non-alcoholic fatty liver disease.

Cardiovascular (CV) disease is the leading cause of mortality in patients with non-alcoholic fatty liver disease (NAFLD). The American Heart Association (AHA) developed 7 CV health metrics (poor, intermediate and ideal health) to improve CV health. To assess population-attributable fractions (PAFs) of CV health metrics to all-cause and CV mortality among NAFLD patients METHODS: We included adult participants from National Health and Nutrition Examination Survey (NHANES 1988-1994) with clinical and mortality data. NAFLD was defined as the presence of hepatic steatosis on ultrasonography in the absence of other chronic liver diseases and excessive alcohol use. A total of 4040 adults with NAFLD and 7515 without were included. NAFLD had fewer ideal health metrics than non-NAFLD (age-standardised prevalence: 20% vs 10% for ≤1 ideal health metric; 5.1% vs 8.7% for ≥6, all P<.001). Following median follow-up of 19.2years (IQR: 17.5-21.0years), 1,136 NAFLD subjects (327 CV deaths) and 1600 non-NAFLD subjects (447 CV deaths) died. Increased number of ideal health metrics (all trend P<.0001) correlated with lower risk for all-cause and CV mortality. If all NAFLD subjects achieved 7 ideal health metrics, 66% of all-cause deaths and 83% of CV deaths were preventable. Among NAFLD subjects, lack of glycaemic control (adjusted PAF=28.3% all-cause; 38.1% CV) and hypertension (adjusted PAF of 23% all-cause; 52.8% CV) were the largest mortality contributors. Ideal physical activity level obtainment provided an adjusted PAF=13.9% all-cause and 13.8% CV mortality. Attainment of ideal CV health metrics provides protection against all-cause and CV deaths in NAFLD.

Prevalence of American Heart Association defined ideal cardiovascular health metrics in Nepal: findings from a nationally representative cross-sectional study.

BackgroundThe ever-increasing burden of non-communicable diseases (NCDs) is posing a serious health challenge for Nepal. This study examines the status of ideal cardiovascular health (ICH) and its associated determinants in Nepal using the American Heart Association (AHA) definition of ICH metrics.MethodsThe AHA has defined ICH as having five to seven of the ideal health metrics. A representative sample from the NCD risk factors STEPS survey 2013 were drawn to analyse the prevalence and sociodemographic determinants of ideal, intermediate and poor cardiovascular health in Nepal. Multivariable logistic regression was used to measure the determinants of ICH.ResultsMore than half of the participants had ICH metrics (51.6%), with the 45–69 y age group having the lowest prevalence of ICH (28%) and females having better cardiovascular health compared with their male counterparts (60.6% vs 41.7%). The prevalence of low intake of fruit and vegetables, tobacco smoking and elevated blood pressure were quite high (99%, 18.8% and 31.4%, respectively). The status of ICH declined with age: individuals 15–29 y of age had 6 times (95% confidence interval [CI] 4.80–8.60) higher odds of having ICH compared with those who were 45–69 y, and it was low among urban residents (referent: rural; adjusted odds ratio 0.77 [95% CI 0.58–1.01]).ConclusionsNearly half of the participants had ICH, which declined with ageing. Further, urban residents had poor cardiovascular health. This highlights the need for a comprehensive population-based intervention targeting elderly and urban residents to improve overall cardiovascular health.

Ideal cardiovascular health and risk of acute myocardial infarction among Finnish men

Background and aimsAcute myocardial infarction (AMI) is associated with high mortality globally and remains a public health burden. We sought to investigate the relation between the American Heart Association's cardiovascular health metrics (CVH) and the risk of AMI among middle-aged Finnish men. MethodsWe used the ongoing population-based Kuopio Ischaemic Heart Disease cohort study comprising men aged 40–62 years at baseline. The CVH metrics was computed among 2584 participants at baseline with health scores ranging from 0 to 7. This was categorized into three groups of CVH metrics as poor (0–2), intermediate (3–4) and ideal (≥5). Multivariate Cox regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of CVH metrics for AMI. ResultsDuring a median follow-up period of 25.2 years, 513 cases of AMI were recorded. Only one participant was able to achieve all the seven ideal health metrics. The risk of AMI decreased continuously with the increasing number of CVH metrics across the range 2–7 (for non-linearity, p = 0.07). Men with ideal CVH metrics had a HR (95% CI) for AMI of 0.28 (CI 0.15–0.55, p < 0.001) compared to those with poor CVH metrics after adjustment for age, alcohol intake and socioeconomic status. The associations remained consistent following further adjustment for history of coronary heart disease and history of type 2 diabetes. ConclusionsIdeal CVH metrics was strongly and linearly associated with reduced risk of AMI among middle-aged Finnish men.

Life\u2019s simple 7 and cardiovascular disease risk knowledge in Hong Kong

BackgroundThis study aimed at investigating the CV health and CV disease knowledge in terms of LS7 score among 3 age groups in Hong Kong.MethodsA cross-sectional multicenter observational study was conducted to observe the CV health and disease risk knowledge in Hong Kong. Elderly subjects were recruited from 15 elderly centers, whereas young adults and the middle-aged were recruited from 6 on-campus health check sessions. Subjects’ demographics, lifestyle behavior and risk knowledge were obtained through questionnaire while their body mass index, random capillary blood glucose, blood cholesterol and blood pressure were measured. LS7 score and risk knowledge score was calculated.ResultsThe LS7 of younger adult, middle-aged and elderly were 10.6 ± 1.3, 9.3 ± 1.9 and 9.7 ± 1.7 respectively. Only 0.6% participants have attained ideal CV health and 35.9% have 5 to 7 ideal CV health metrics. Elderly performed worst in risk knowledge with a score of 8.1 ± 3.3 while young adult and middle-aged were similar (9.6 ± 1.8 and 9.7 ± 1.5). 71% of the participants correctly identified ≥9 components. Logistic regression revealed that subjects aged ≤65 years (OR 2.341, 95% CI 1.779 to 3.080) and with tertiary education (OR 2.031, 95% CI 1.527 to 2.701) were more likely to obtain optimum LS7. No association was found between having optimum LS7 and full knowledge.ConclusionOnly few adults in this study population had ideal CV health as defined by AHA. Knowledge has no association but young age and tertiary education has positive association with CV health.

3110 The association between components of the Life’s Simple Seven and incident end stage renal disease in the Southern Community Cohort Study

OBJECTIVES/SPECIFIC AIMS: The Life’s Simple 7 (LS7) metric was created by the American Heart Association with the goal of educating the public on seven modifiable factors that contribute to heart health. While it is well documented that these ideal health behaviors lower risk of cardiovascular disease (CVD) in the general population, the association between the LS7 ideal health metrics and end stage renal disease (ESRD) risk has not been examined in a lower socioeconomic population at high risk for both ESRD and CVD. Our objective is to examine the association between the LS7 score and incident ESRD in a cohort of white and black men and women in the southeastern US, where rates of CVD and ESRD are high. METHODS/STUDY POPULATION: The Southern Community Cohort Study recruited ~86,000 low-income blacks and whites in the southeastern US (2002-2009). Utilizing a nested case-control design, our analysis included 1628 incident cases of ESRD identified via linkage of the cohort with the United States Renal Data System (USRDS) from January 1, 2002 to March 31, 2015. Controls (n = 4884) were individually matched 3:1 with ESRD cases based on age, sex, and race. Demographic, medical, and lifestyle information were obtained via baseline questionnaire. The AHA definitions for ideal health were used for non-smoking (never or quit &gt;12 months), body mass index (BMI&lt;25kg/m2) and physical activity (&gt;75 min/week of vigorous physical activity or &gt;150min/week of moderate/vigorous activity). Modified definitions were used for consuming a healthy diet [Healthy Eating Index (HEI10) score&gt;70] and for blood pressure, fasting plasma glucose, and total cholesterol, based on self-reported no history of diagnosis of hypertension, diabetes, and hypercholesterolemia, respectively. The number of ideal health parameters were summed to generate the LS7 score, which ranged from 0-7 with higher scores indicating more ideal health. Adjusted odds ratios (95% confidence intervals) for incident ESRD associated with LS7 score were calculated using conditional logistic regression models, adjusting for income and education. The SCCS ESRD case-cohort dataset will be available by TS 2019 and analyses will be completed to adjust for baseline estimated glomerular filtration rate (eGFR) as a marker of kidney function and to examine whether eGFR modifies the relationship between LS7 and incident ESRD. RESULTS/ANTICIPATED RESULTS: At baseline, mean age was 54 years, 55% (3600) of participants were women, and 87% (5656) were black. A total of 58% (943) of ESRD cases were non-smokers compared to 54% (2633) of controls. ESRD cases had higher prevalence of BMI&gt;25 kg/m2 (81% vs. 74%), hypertension (84% vs. 59%), hypercholesterolemia (48% vs. 34%), and diabetes (66% vs. 22%) compared to controls. A total of 18% (839) of controls and 12% (194) of ESRD cases met ideal exercise recommendations, and 20% of either cases (302) or controls (916) had a HEI10 score above 70. The median LS7 score for controls and ESRD cases was 3 and 2, respectively, and 17% (983) of participants had a low score (0-1) while 2% (105) met 6 or 7 ideal health metrics. Higher LS7 score was associated with lower odds of ESRD (P-trend&lt;0.001). Participants with LS7 score &gt;3 (above median) had 75% reduced odds of ESRD (OR 0.25; 95% CI 0.22, 0.29) compared to those with a score of 2 or less. DISCUSSION/SIGNIFICANCE OF IMPACT: In the SCCS population, the presence of any 3 or more ideal health behaviors is associated with reduced odds of developing ESRD. The components of the LS7 represent important modifiable risk factors that may be targets for future interventions driven by the patient. The attributable risk due to each factor is needed to dissect which ideal behaviors are the most beneficial.

Ideal Cardiovascular Health and Arterial Stiffness in Spanish Adults—The EVIDENT Study

Studies concerning ideal cardiovascular (CV) health and its relationship with arterial stiffness are lacking. This study examined the association between arterial stiffness with ideal CV health as defined by the American Heart Association, across age groups and gender. The cross-sectional study included 1365 adults. Ideal CV health was defined as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity, and Mediterranean diet adherence) and 3 factors (total cholesterol, blood pressure, and glycated hemoglobin). Patients were grouped into 3 categories according to their number of ideal CV health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). We analyzed the pulse wave velocity (PWV), the central and radial augmentation indexes, and the ambulatory arterial stiffness index (AASI). The ideal CV health profile was inversely associated with lower arterial radial augmentation index and AASI in both genders, particularly in middle-aged (45-65 years) and in elderly subjects (>65 years). Also in elderly subjects, adjusted models showed that adults with at least 3 health metrics at ideal levels had significantly lower PWV than those with 2 or fewer ideal health metrics. An association was found between a favorable level of ideal CV health metrics and lower arterial stiffness across age groups.

Sex disparities in ideal cardiovascular health

ObjectiveTo quantify the gap in the distribution of ideal cardiovascular health (CVH) between men and women accounting for comorbidities, socioeconomic and psychological confounding factors.MethodsA cross-sectional analysis was conducted among 9012...

Abstract P007: Sex-Specific Disparities in Risk Factor Control of Patients Undergoing Elective Percutaneous Coronary or Peripheral Intervention

Introduction: The American Heart Association (AHA) developed 7 health metrics to define “ideal cardiovascular health” in its 2020 Impact Goal. Sex-specific disparities in attainment of the 7 health metrics in patients undergoing elective percutaneous or peripheral interventions has not been well characterized. Methods: We interviewed 1,517 patients (1,127 males and 390 females) undergoing elective percutaneous coronary or peripheral intervention at a large tertiary care center between November 2010 and March 2015. Survey data was used to reconstruct the 7 health metrics (blood pressure, physical activity, cholesterol, diet, weight, smoking status, and metabolic control). Multivariable linear regression was performed to identify characteristics associated with ideal metric attainment in the overall cohort and when stratified by sex. Results: Overall, males were younger, less likely to be white, more likely to be married, and had higher levels of education and higher prevalence of prior coronary artery disease than females (p&lt;.05 for each). Males achieved fewer ideal health metrics than females (2.0 ± 1.2 vs 2.3 ± 1.1, p&lt;.01), including poorer attainment of the ideal smoking (p&lt;.01), physical activity (p&lt;.01), and diet health metrics (p&lt;.05). Females had poorer attainment of the ideal weight (p&lt;.05) and cholesterol health metrics (p=.01). After multivariable adjustment, males achieved fewer ideal health metrics than females (p&lt;.01; Table). Sex-specific differences are presented in the Table, which includes single marital status and depression as negative predictors of ideal metric attainment in males, and a reduced ejection fraction as a negative predictor in females. Conclusions: Attainment of the 7 AHA ideal health metrics is low in both males and females undergoing elective percutaneous coronary or peripheral intervention. Sex-specific disparities in risk factor control illustrate interesting areas for further exploration into the predictors of behavior that may guide future targeted interventions.

Abstract P365: Effects of a Health Partner Intervention on Arterial Health

Introduction: Lifestyle modification is effective for cardiovascular disease prevention. Whether lifestyle intervention also preserves vascular health is less clear. Our study examined the role of a Health Partner-administered lifestyle intervention on vascular function. Hypothesis: Lifestyle intervention improves and preserves vascular function. Methods: A total of 711 university employees (48±11 years, 66% women, 22.5% Black) enrolled in a program that promoted healthier lifestyles at Emory University. Participants collaborated with a Health Partner to generate a personalized plan focused on achieving ideal health metrics. Anthropometric, laboratory and vascular function measurements were performed at baseline and at 1-year and 2-years of follow-up. Arterial stiffness was assessed by carotid-femoral pulse wave velocity and radial tonometry-derived central augmentation index. Microvascular function was assessed as digital reactive hyperemia index. Flow-mediated dilation was measured using ultrasound. The sample was divided into individuals within the lowest tertile and those in the upper two tertiles for vascular function at baseline. Paired t-test was used to assess the changes in vascular functions at 1 and 2 years of follow-up compared to baseline. Results: At each of the 1-year and 2-year follow-up visits, vascular function improved in the group within the abnormal tertile at baseline. Flow-mediated dilation increased by 1.6% and 2.0% (P&lt;0.001) respectively, pulse wave velocity decreased by 0.85 m/s and 0.93 m/s (P&lt;0.001), central augmentation index was lower by 3.4 and 3.2 (P&lt;0.001), and microvascular function assessed by reactive hyperemia index improved by 0.48 and 0.52 (P&lt;0.001). In those within the upper two tertiles, pulse wave velocity did not significantly change, but flow-mediated dilation and reactive hyperemia index showed significant decline at 2 years of follow up. Conclusion: A personalized, goal directed Health Partner intervention was associated with better vascular stiffness, endothelial and microvascular function in those with baseline abnormal values. These effects were evident at 1 year following enrollment and were sustained for 2 years. Whether the impact of Health Partner intervention on vascular function improves long-term morbidity and mortality needs further investigation in a controlled design.

IDEAL CARDIOVASCULAR HEALTH METRICS IN COUPLES: A COMMUNITY-BASED POPULATION STUDY

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality. Better understanding of CVD determinants is needed to decrease CVD risk. We hypothesized that ideal CVD health metrics are mostly concordant among heterosexual spousal or cohabitating couples. Methods: We

Effects of a Health-Partner Intervention on Cardiovascular Risk.

BackgroundLifestyle modifications are first‐line measures for cardiovascular disease prevention. Whether lifestyle intervention also preserves cardiovascular health is less clear. Our study examined the role of a Health Partner–administered lifestyle intervention on metrics of ideal cardiovascular health.Methods and ResultsA total of 711 university employees (48±11 years; 66% women, 72% Caucasian/22.5% African Americans) enrolled in a program that promoted healthier lifestyles at Emory University (Atlanta, GA). Anthropometric, laboratory, and physical activity measurements were performed at baseline and at 6 months, 1 year, and 2 years of follow‐up. Results were utilized by the Health Partner to generate a personalized plan aimed at meeting ideal health metrics. Compared to baseline, at each of the 6‐month, 1‐year, and 2‐year follow‐up visits, systolic blood pressure was lower by 3.6, 4.6, and 3.3 mm Hg (P<0.001), total cholesterol decreased by 5.3, 6.5, and 6.4 mg/dL (P<0.001), body mass index declined by 0.33, 0.45, and 0.38 kg/m2 (P<0.001), and the percentage of smokers decreased by 1.3%, 3.5%, and 3.5% (P<0.01), respectively. Changes were greater in those with greater abnormalities at baseline. Finally, the American Heart Association “Life's Simple 7” ideal cardiovascular health score increased by 0.28, 0.40, and 0.33 at 6 month, 1 year, and 2 years, respectively, compared to baseline visit.ConclusionsA personalized, goal‐directed Health Partner intervention significantly improved the cardiometabolic risk profile and metrics of cardiovascular health. These effects were evident at 6 months following enrollment and were sustained for 2 years. Whether the Health Partner intervention improves long‐term morbidity and mortality and is cost‐effective needs further investigation.

Ideal Cardiovascular Health and Incident Cardiovascular Events: The Jackson Heart Study.

The epidemiology of American Heart Association ideal cardiovascular health (CVH) metrics has not been fully examined in African Americans. This study examines the associations of CVH metrics with incident cardiovascular disease (CVD) in the Jackson Heart Study, a longitudinal cohort study of CVD in African Americans. Jackson Heart Study participants without CVD (n=4,702) were followed prospectively between 2000 and 2011. Incidence rates and Cox proportional hazard ratios estimated risks for incident CVD (myocardial infarction, stroke, cardiac procedures, and CVD mortality) associated with seven CVH metrics by sex. Analyses were performed in 2015. Participants were followed for a median of 8.3 years; none had ideal health on all seven CVH metrics. The prevalence of ideal health was low for nutrition, physical activity, BMI, and blood pressure metrics. The age-adjusted CVD incidence rate (IR) per 1,000 person years was highest for individuals with the least ideal health metrics: zero to one (IR=12.5, 95% CI=9.7, 16.1), two (IR=8.2, 95% CI=6.5, 10.4), three (IR=5.7, 95% CI=4.2, 7.6), and four or more (IR=3.4, 95% CI=2.0, 5.9). Adjusting for covariates, individuals with four or more ideal CVH metrics had lower risks of incident CVD compared with those with zero or one ideal CVH metric (hazard ratio, 0.29; 95% CI=0.17, 0.52; p<0.001). African Americans with more ideal CVH metrics have lower risks of incident CVD. Comprehensive preventive behavioral and clinical supports should be intensified to improve CVD risk for African Americans with few ideal CVH metrics.

Ideal cardiovascular health status and its association with socioeconomic factors in Chinese adults in Shandong, China.

BackgroundCardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world. In 2010, a goal released by the American Heart Association (AHA) Committee focused on the primary reduction in cardiovascular risk.MethodsData collected from 7683 men and 7667 women aged 18–69 years were analyzed. The distribution of ideal cardiovascular health metrics based on 7 cardiovascular disease risk factors or health behaviors in according to the definition of AHA was evaluated among the subjects. The association of the socioeconomic factors on the prevalence of meeting 5 or more ideal cardiovascular health metrics was estimated by logistic regression analysis, and a chi-square test for categorical variables and the general linear model (GLM) procedure for continuous variables were used to compare differences in prevalence and in means among genders.ResultsSeven of 15350 participants (0.05 %) met all 7 cardiovascular health metrics. The women had a higher proportion of meeting 5 or more ideal health metrics compared with men (32.67 VS.14.27 %). The subjects with a higher education and income level had a higher proportion of meeting 5 or more ideal health metrics than the subjects with a lower education and income level. A comparison between subjects with meeting 5 or more ideal cardiovascular health metrics with subjects meeting 4 or fewer ideal cardiovascular health metrics reveals that adjusted odds ratio [OR, 95 % confidence intervals (95 % CI)] was 1.42 (0.95, 2.21) in men and 2.59 (1.74, 3.87) in women for higher education and income, respectively.ConclusionsThe prevalence of meeting all 7 cardiovascular health metrics was low in the adult population. Women, young subjects, and those with higher levels of education or income tend to have a greater number of the ideal cardiovascular health metrics. Higher socioeconomic status was associated with an increasing prevalence of meeting 5 or more cardiovascular health metrics in women but not in men. It’s urgent to develop comprehensive population-based interventions to improve the cardiovascular risk factors in Shandong Province in China.

Association Between Cardiovascular Health Metrics and Cancer Mortality in Men and Women

BACKGROUND: Whether cardiovascular health (CV) metrics relates to cancer mortality in US population remains less explored. PURPOSE: We investigated the combined effects of 7 ideal cardiovascular health metrics on cancer mortality in men and women. METHODS: We followed a total of 16,506 men and women, aged 20 to 85 years, who participated in the 1999-2010 National Health Examination Survey. All participants completed baseline lifestyle factors and lifestyle behavior questionnaires. The 7 ideal CV metrics were defined as never smoked, physically active, a healthy diet, waist girth (<102/88 cm), untreated blood pressure (<120/80 mmHg), untreated total cholesterol (<200 mg/dL), and untreated fasting glucose (<100 mg/dL) defined by the American Heart Association. We further categorized these variables as having 0, 1, 2, 3, 4, 5 to 7 combined cardiovascular health metrics. RESULTS: During an average of 8.6 years of follow-up (141,292 person-years), there were a total of 337 cancer deaths. Men and women with 5 to 7 ideal CV metrics had a lower cancer deaths (3.1%), while men and women with 3 or less ideal CV metrics had greater cancer deaths (89.1%). After adjustment for age, sex, race, and multiple baseline risk factors, men and women with all 5 to 7 combined ideal health metrics had a 70% (95% CI: 14% to 72%) lower risk of cancer mortality compared with men and women with zero ideal health metrics. The risks of cancer mortality across 0, 1, 2, 3, 4, and 5 to 7 ideal health metrics were (95% CI) 1.00 (referent), 0.92 (0.65, 1.31), 0.75 (0.51, 1.12), 0.57 (0.40, 0.83), 0.56 (0.32, 0.96), and 0.40 (0.18, 0.86) (p for trend <0.001), respectively. Men and women with increasing number ideal health metrics had a substantially lower risk of cancer mortality. Men and women with 5 to 7 compared with 0 combined ideal health metrics had a longer life expectancy by 11.8 years (95% CI: 1.0 to 20.5 years). Approximately 46% (95% CI: 11% to 73%) of all cancer deaths might have been avoided if men and women had adopted 5 or more combined health factors and healthy lifestyle behaviors. CONCLUSIONS: The AHA’s 7 ideal cardiovascular health metrics is associated with lower risk of cancer mortality and longer life expectancy in men and women. This study was supported by Medi Plus Solution Co., Ltd.