Levels Of Ideal Cardiovascular Health Research Articles

Time, Technology, Social Support, and Cardiovascular Health of Emerging Adults With Type 1 Diabetes.

Emerging adults with Type 1 diabetes (T1DM) face an increased risk of cardiovascular disease; however, there are both barriers and facilitators to achieving ideal cardiovascular health in this stage of their lives. The aim of this study was to qualitatively explore the barriers and facilitators of achieving ideal levels of cardiovascular health in a sample of emerging adults with T1DM ages 18-26 years. A sequential mixed-methods design was used to explore achievement of ideal cardiovascular health using the seven factors defined by the American Heart Association (smoking status, body mass index, physical activity, healthy diet, total cholesterol, blood pressure, and hemoglobin A1C [substituted for fasting blood glucose]). We assessed the frequency of achieving ideal levels of each cardiovascular health factor. Using Pender's health promotion model as a framework, qualitative interviews explored the barriers and facilitators of achieving ideal levels of each factor of cardiovascular health. The sample was mostly female. Their age range was 18-26 years, with a diabetes duration between 1 and 20 years. The three factors that had the lowest achievement were a healthy diet, physical activity at recommended levels, and hemoglobin A1C of <7%. Participants described lack of time as a barrier to eating healthy, being physically active, and maintaining in-range blood glucose levels. Facilitators included the use of technology in helping to achieve in-range blood glucose and social support from family, friends, and healthcare providers in maintaining several healthy habits. These qualitative data provide insight into how emerging adults attempt to manage their T1DM and cardiovascular health. Healthcare providers have an important role in supporting these patients in establishing ideal cardiovascular health at an early age.

The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study

BackgroundHigher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated the mediational role of aldosterone in the association of 5 components of ICH (cholesterol, body mass index (BMI), physical activity, diet and smoking) with incident CVD and the mediational role of blood pressure (BP) and glucose in the association of aldosterone with incident CVD in a cohort of African Americans (AA). MethodsThe Jackson Heart Study is a prospective cohort of AAs adults with data on CVD outcomes. Aldosterone, ICH metrics and baseline characteristics were collected at exam 1 (2000–2004). ICH score was developed by summing 5 ICH metrics (smoking, dietary intake, physical activity, BMI, and total cholesterol) and grouped into two categories (0–2 and ≥3 metrics). Incident CVD was defined as stroke, coronary heart disease, or heart failure. Cox proportional hazard regression models were used to model the association of categorical ICH score with incident CVD. The R Package Mediation was utilized to examine: 1) The mediational role of aldosterone in the association of ICH with incident CVD and 2) The mediational role of blood pressure and glucose in the association of aldosterone with incident CVD. ResultsAmong 3,274 individuals (mean age: 54±12.4 years, 65% female), there were 368 cases of incident CVD over a median of 12.7 years. The risk of incident CVD was 46% lower (HR: 0.54; 95%CI 0.36, 0.80) in those with ≥3 ICH metrics at baseline compared to 0–2. Aldosterone mediated 5.4% (p = 0.006) of the effect of ICH on incident CVD. A 1-unit increase in log-aldosterone was associated with a 38% higher risk of incident CVD (HR 1.38, 95%CI: 1.19, 1.61) with BP and glucose mediating 25.6% (p<0.001) and 4.8% (p = 0.048), respectively. ConclusionAldosterone partially mediates the association of ICH with incident CVD and both blood pressure and glucose partially mediate the association of aldosterone with incident CVD, emphasizing the potential importance of aldosterone and ICH in risk of CVD among AAs.

Prevalence, incidence and associations of dementia with cardiovascular risk factors in the Latin American and Caribbean population. A population‐based cohort study of 10/66 Dementia Research Group

AbstractBackgroundLatin America and the Caribbean (LAC) countries are experiencing unprecedentedly rapid demographic ageing. Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. The present study aimed to examine the prevalence, incidence and associations of socioeconomic determinants and cardiovascular risk factors with dementia across six LAC countries.MethodsThe 10/66 Dementia Research Group has carried out population‐based catchment area surveys, using a common protocol, in six Latin‐American countries Cuba, Dominican Republic, Mexico, Peru, Puerto Rico and Venezuela of all over 65 year old (n = 12 704). An incidence wave was conducted 4 ‐5 years after cohort inception, 8 502 participants were reinter viewed, contributing 34 000 person‐years of follow‐up. The outcomes were 10/66 dementia and DSM IV dementia. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risks regression to adjust for risk of death.ResultsThe prevalence of dementia varied widely across different countries, ranging from 4.8% in Peru and 11.7% in Puerto Rico and the Dominican Republic. Incidence of 10/66 dementia varied between 18.2 (95% CI 14.3‐23.0) per 1000 person‐years in Peru to 30.4 (25.5‐36.3) per 1000 person‐years in Mexico. Being male, having higher education and younger age were all protective of dementia. Specific cognitive tests including literacy, verbal fluency and motor sequencing had also similar protective associations with dementia, providing more supporting evidence for the cognitive reserve hypothesis. Compared to poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia both in the unadjusted (subhazard ratio for moderate: 0.77; ideal: 0.59) and adjusted models (moderate: 0.73; ideal: 0.66).ConclusionsThe prevalence of dementia in the older Latin American and Caribbean population is high. Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries

Abstract P210: The Social Distribution Of Ideal Cardiovascular Health: A Global Systematic Review

Introduction: Numerous studies have examined the social determinants of ideal cardiovascular health (ICVH) around the world, but no work has summarized evidence to date. This study aimed to systematically review findings on the social distribution of ICVH globally, and to compare trends in high-income countries (HICs) vs. low/middle-income countries (LMICs). Methods: In November 2019, we systematically searched PubMed, Embase, and LILACS for observational studies published after the American Heart Association (AHA) defined ICVH as a combination of health factors and behaviors in 2010. Search terms included ICVH/Life’s Simple 7 and a pre-defined set of social determinants of health (i.e., education, income/wealth, socioeconomic status (SES), employment, occupation, and race/ethnicity). Each abstract was reviewed by two independent researchers. Studies were included if associations between a composite measure of ICVH and a social determinant of health was quantified using statistical methods. We evaluated risk of bias using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. Overall findings and comparisons between HICs and LMICs (defined by World Bank guidelines) were summarized narratively. Results: A total of 33 studies met inclusion criteria. Only 8 studies were from LMICs (n=4 from China), while 25 were from HICs (n=19 from the US). The most commonly assessed social determinants were education (n=18) and income/wealth (n=17). In both HICs and LMICs, few studies examined occupation or area-level measures, like rurality/urbanicity. Most studies were cross-sectional (n=27). Two thirds of studies and had a moderate (n=14, 43%) or high (n=8, 24%) risk of bias, but no systematic differences were noted by country setting. Nearly half of studies used composite ICVH measures that were of moderate or poor quality (i.e., based on only self-reported data and/or unvalidated instruments), and only 15% of studies (n=5) assessed each ICVH component using the exact criteria defined by the AHA. Despite substantial heterogeneity in how ICVH measures were derived and analyzed (e.g., as a binary, categorical, or count variable), fairly consistent associations were observed between higher levels of ICVH and higher social status (higher education, income/wealth, racial/ethnic majority status) across both HICs and LMICs. Studies of occupation (n=6, all from HICs) and area-level measures (n=4, 3 from LMICs) were less conclusive. Conclusion: Associations between higher social status and ICVH were noted in both HICs and LMICs, but most evidence was based on correlational data from cross-sectional studies in the US, primarily in relation to education and income. Important gaps in the literature include studies from LMICs, longitudinal designs to improve causal inference, and investigations of occupation, rurality/urbanicity, and race/ethnicity in non-US settings.

Cardiovascular health and dementia incidence among older adults in Latin America: Results from the 10/66 study.

Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. This study aimed to assess the longitudinal association between CVH and dementia in six Latin American countries. We analyzed longitudinal data from the 10/66 study that included nondementia residents at baseline aged 65+ in six Latin American countries (n=6447) and were followed up for 3years. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risk regression to adjust for risk of death. The sample included 6.2% participants with poor (0-5), 81.0% with moderate (6-10), and 12.8% with ideal CVH (11-14). At follow-up, 9.4% had developed dementia and 13.1% had died. Compared with those with poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia in both the unadjusted (subhazard ratio for moderate, 0.77; ideal, 0.59) and adjusted models (moderate, 0.73; ideal, 0.66). Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries.

Low levels of ideal cardiovascular health in a semi-urban population of Western Nepal: a population-based, cross-sectional study

BackgroundThe aim of this study was to assess the status of cardiovascular health among a semi-urban population of Nepal, and determine factors associated with ideal cardiovascular health.MethodsA population-based, cross-sectional study...

A3811 Low levels of ideal cardiovascular health among adults in a semi-urban area of Western Nepal

Objectives: The aim of this study was to assess the status of cardiovascular health among a semi-urban population in Western Nepal and determine the factors associated with ideal cardiovascular health. Methods: A population-based cross-sectional study was conducted among 2,310 adults among the population aged ≥25 years in Pokhara-Lekhnath Metropolitan area in Western Nepal. The ideal, intermediate and poor cardiovascular health was defined as presence of 6–7, 4–5 and 1–3 ‘health metrics index’, respectively among a list of risk factors: current smoking, body mass index, physical activity, fruits and vegetables intake, harmful alcohol use, blood pressure, and fasting glucose levels. We used univariate and multivariable Poisson regression models adjusting for sex, age groups, ethnicity, education level and socioeconomic status and calculated the prevalence ratios with 95% Confidence Intervals (CIs). Results: Only 14.3% of the participants had ideal cardiovascular health, whereas 67.0% and 18.7% of the participants had intermediate and poor cardiovascular health, respectively. Age groups 45–54 years (prevalence ratio 0.88, 95% CI: 0.83 to 0.94, P < 0.001) and 55–64 years (prevalence ratio 0.84, 95% CI: 0.79 to 0.90, P < 0.001) were associated with low prevalence of ideal cardiovascular health compared to the age group 35–44 years. Moreover, being male (prevalence ratio 0.83, 95% CI: 0.77 to 0.99, P < 0.001) and Indigenous ethnicity (prevalence ratio 0.89, 95% CI: 0.85 to 0.93, P < 0.001) were associated with low prevalence of ideal cardiovascular health. Conclusion: A low ideal cardiovascular health and higher intermediate cardiovascular health prevalence demonstrates a slowly maturing cardiovascular disease epidemic in Nepal. Urgent efforts are needed to counter rapidly deteriorating cardiovascular health.

Abstract 021: Higher Levels of Ideal Cardiovascular Health Are Associated With Lower Risk of Incident Type 2 Diabetes Mellitus Among Individuals With Normal Fasting Glucose but Not Impaired Fasting Glucose: The Reasons for Geographic and Racial Differences in Stroke Study

Aims/hypothesis: Ideal cardiovascular health (ICH) is associated with lower risk of incident diabetes, but whether this association varies by baseline glycemia (normal [&lt;100 mg/dL] vs. impaired fasting glucose [100-125 mg/dL]) remains to be clarified. We assessed the incidence of diabetes based on American Heart Association (AHA) ICH components stratified by glycemic status to determine whether ICH is more effective for primordial or primary prevention of diabetes among middle-aged and older adults. Methods: This study included 7,662 non-Hispanic whites and African Americans from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study without prevalent diabetes at baseline (2003-2006), who completed the follow-up exam (2013-2016). Participants were categorized as having ideal, intermediate or poor cardiovascular health, as defined by the AHA 2020 Impact Goals, based on baseline ICH components (total cholesterol, blood pressure, dietary intake, tobacco use, physical activity and body-mass index (BMI)). We categorized participants based on their total number of components that were ideal (0-1 “poor”, 2-3 “intermediate”, and 4+ “ideal”). Incident rate ratios (IRR) were calculated using modified poisson regression adjusting for age, sex, education, income, race, alcohol use, estimated glomerular filtration rate, urine albumin:creatinine ratio and high-sensitivity C-reactive protein. After confirming significant interactions with multiplicative interaction terms and application of likelihood ratio test, we stratified by glycemic status (normal vs. impaired fasting glucose). Results: Among REGARDS participants (mean age 63.0 [SD 8.4] years, 56% female, 26% African American), there were 560 incident diabetes cases (median follow-up 9.5 years). Overall, those with 2-3 and 4+ ICH components vs. 0-1 components had 31% (IRR 0.69; 95% CI 0.61, 0.79) and 71% lower (IRR 0.29; 95% CI 0.20, 0.42) risk of diabetes, respectively. Among 5,930 participants with normal fasting glucose, these risks were 36% (IRR 0.64; 95% CI 0.52, 0.79) and 80% lower (IRR 0.20; 95% CI 0.10, 0.37), while among 1,732 participants with baseline impaired fasting glucose these risks were 8% (IRR 0.92; 95% CI 0.80,1.07) and 13% lower (IRR 0.87; 95% CI 0.58,1.30) (p for interaction by baseline glucose status &lt;0.0001). Conclusions/interpretation: Meeting an increasing number of ideal levels of dietary intake, physical activity, smoking, blood pressure, cholesterol and BMI was associated with a dose-dependent lower risk of diabetes for individuals with normal fasting glucose but not impaired fasting glucose. This suggests the AHA 2020 guidelines may be more effective for primordial versus primary prevention of diabetes among middle-aged and older adults.

Ideal Cardiovascular Health in the southern cone of Latin America

ObjectiveThe American Heart Association developed the concept of ‘Ideal Cardiovascular Health’, which is based on the presence of ideal levels across seven health factors. The goal of this study is to assess the prevalence of Ideal Cardiovascular Health in the Southern Cone of Latin America. Study designWe conducted a cross-sectional analysis as part of CESCAS I cohort. MethodsThis report included 5458 participants aged between 35 and 75 years who were selected using stratified multistage probability sampling in Argentina, Chile and Uruguay. Interviews included demographic information, the International Physical Activity Questionnaire, and a food frequency questionnaire on dietary habits. Participants were classified as current, former or non-smokers. Weight, height and blood pressure were measured by trained personnel, and fasting cholesterol and glucose plasma levels were measured. ResultsOnly 0.1% (95% confidence interval [CI]: 0.0–0.2) met the seven criteria that define the Ideal Cardiovascular Health. The least prevalent healthy behaviour was having a healthy diet: 0.5% (95% CI: 0.3–0.7), while the least prevalent health factor was having blood pressure < 120/80 mmHg: 23.6% (95% CI: 22.1–25.0). ConclusionsThe prevalence of Ideal Cardiovascular Health is very low in a representative sample of population from the Southern Cone of Latin America, and the levels of healthy lifestyle behaviours are even lower than ideal biochemical parameters. These results highlight the challenge of developing strategies to improve the levels of Ideal Cardiovascular Health at primary prevention levels.

Cardiovascular health in Brazilian state capitals 1.

ResumeObjective:to estimate the prevalence of ideal cardiovascular health indicators in the Brazilian population, according to gender, age, education and region of residence. Method:cross-sectional study that used data from 41,134 participants of the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). The ideal cardiovascular health assessment considers four behavioral factors: not smoking; body mass index less than 25 kg/m2; practicing physical activity, eating fruits and vegetables five or more times per day; and two clinical factors (no diagnosis of diabetes or hypertension). The sum of factors at ideal levels results in a score ranging from zero (worse cardiovascular health) to six (ideal cardiovascular health). Results:considering the six factors, only 3.4% of the studied population presented ideal levels of cardiovascular health, with the majority of participants (57.6%) presenting three or four ideal factors. Women had higher prevalence of ideal cardiovascular health (3.8% versus 2.9% for men) (p < 0.0001). Conclusion:the findings of this study are consistent with the elevated risk of mortality from cardiovascular disease, observed in the Brazilian population. This may contribute to a better understanding of the scenario of cardiovascular health in the urban population of the country.

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

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

The association of ideal cardiovascular health with incident type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis.

Levels of ideal cardiovascular health (ICH) and incident type 2 diabetes mellitus have not been examined in a multiethnic population. We assessed the total and race/ethnicity-specific incidence of diabetes based on American Heart Association (AHA) ICH components. Incident diabetes was assessed among 5341 participants in the Multi-Ethnic Study of Atherosclerosis without prevalent diabetes between 2002 and 2012. ICH components (total cholesterol, BP, dietary intake, tobacco use, physical activity and BMI) were assessed at baseline and participants were categorised as having ideal, intermediate or poor cardiovascular health, as defined by the AHA 2020 impact goals. We developed a scoring system based on the number of ICH components (0-1 'poor', 2-3 'intermediate', and ≥4 'ideal'). HRs were calculated using Cox models. During a median follow-up of 11.1years, we identified 587 cases of incident diabetes. After multivariable adjustment, participants with 2-3 and ≥4 ICH components vs 0-1 components had a 34% lower (HR 0.66; 95% CI 0.54, 0.80) and a 75% lower (HR 0.25; 95% CI 0.18, 0.35) diabetes incidence, respectively. There were significant differences by race/ethnicity: African-American and Hispanic-American participants with ≥4 ICH components had diabetes incidence rates per 1000 person-years of 5.6 (95% CI 3.1, 10.1) and 10.5 (95% CI 6.7, 16.4), respectively, compared with 2.2 (95% CI 1.3, 3.7) among non-Hispanic white Americans. Meeting an increasing number of AHA 2020 impact goals for dietary intake, physical activity, smoking, BP, cholesterol and BMI was associated with a dose-dependent lower risk of diabetes with significant variation by race/ethnicity.

Abstract P004: Estimating the Mortality Benefits of Ideal Cardiovascular Health: A Dose-response Meta-analysis

Background: Studies have shown that individuals with higher levels of Ideal Cardiovascular Health (ICVH) metrics have favorable health outcomes. However, none of these studies quantify the reduction in the risk of death per unit increase in ICVH. In this study, we estimated the reduction in CVD and all-cause mortality attributable to per unit improvement in ICVH. Methods: Five studies identified through a literature search were included. Major differences in the re-categorization of the 7 ICVH metrics were noted, with studies having between 3-6 groups. Reference groups also ranged from 0 to ≤2 ideal CVH metrics. Because of these differences, risk reduction per unit increase in ICVH was not comparable across studies. To overcome these challenges, we quantified association between ICVH metrics and all-cause/CVD mortality using a dose-response meta-analysis, so all exposure categories contribute to a defined pooled association and heterogeneity is reduced by accounting for values assigned to these qualitative metrics. Results: Original data and meta-analysis model of studies assessing CVD mortality are shown in the figure. There was a significant linear trend ( p &lt; 0.001) with moderate heterogeneity (Q test = 12, p = 0.02 and I2 = 66 %). Each unit increase in ICVH metric was associated with 18% (95% CI: 12, 23) reduction in HR. In all-cause mortality analysis (graph not shown), there was also a significant linear trend (p &lt; 0.001) with moderate heterogeneity (Q test = 18, p = 0.003, and I2 = 72 %). Each unit increase in ICVH metric was associated with a 10% (95% CI: 6, 13) reduction in HR for all cause mortality. Conclusion: Our study is the first meta-analysis to demonstrate a dose-response impact of ICVH on mortality. The novel dose-response design allowed us to investigate strength, direction and type of association as well as overcomes challenges posed by heterogeneity ICVH metrics categorization while preserving the statistical control for confounding variables that was conducted in the individual studies.

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....

Abstract P397: Cardiovascular Health Among US Adults In Metropolitan And Micropolitan Statistical Areas

Background: Cardiovascular disease (CVD) is the leading cause of death in the US and primary risk factors for CVD are well known. Promoting the ideal state of cardiovascular (CV) health factors and behaviors has been previously defined as CV health. The objective of this study is to assess CV health among US adults in urban areas. Methods: Data from the Behavior Risk Factor Surveillance System (BRFSS) 2011 were used for analysis and included 307,101 participants from 198 metropolitan and micropolitan statistical areas (MMSA) with an adequate sample size for estimates (range: 493 to 9,241 participants). Seven indicators were used to define ideal levels of CV health using self-reported data: no hypertension, no diabetes, no high cholesterol, no current smoking, no obesity, and meeting physical activity guidelines and fruit and vegetable consumption targets. Each metric was given a score (0=no, 1=yes) and summed. The percentage achieving ideal CV health (all 7 metrics at ideal level), good CV health (6-7 metrics at ideal levels), poor CV health (0-2 metrics at ideal levels), and the mean CV health score were calculated for each MMSA. Estimates and 95% confidence intervals were age-standardized. Results: Overall, 16.7% (16.4-17.1) and 11.5% (11.2-11.8) of participants among the 198 MMSAs had good and poor CV health, respectively. Few respondents in MMSAs met all ideal CV health standards (&lt;1%), likely driven by the limited number of participants meeting fruit and vegetable consumption targets (5.7%) in this sample. The overall mean CV health score was 3.91 (3.90-3.92). The percentage of participants with good CV health varied from 3.0% (1.5-5.8) (Mobile, AL) to 23.8% (17.0-32.3) (Kalispell, MT). The percentage of participants with poor CV health varied from 6.1% (4.2-8.6) (Boulder, CO) to 26.5% (18.2-36.8) (Kingsport-Bristol-Bristol, TN-VA). The mean CV health score ranged from 3.44 (3.2-3.7) (Kingsport-Bristol-Bristol, TN-VA) to 4.7 (4.5-4.9) (Boulder, CO). Conclusions: Across select US MMSAs, few adults met ideal CV health standards, and only 16% had good CV health. CV health varied significantly across MMSAs. Reducing the burden and mitigating the deleterious effects of CVD can be achieved through the promotion of CV health. Local clinical and public health agencies have the unique opportunity to tailor evidenced-based interventions to promote CV health in their populations. The methodology and findings used in this study can be utilized by local jurisdictions to target lagging health indicators with focused interventions.

EDITORIAL: No-Pharmacological Intervention: Pomegranate Juice for the Management of Hypertension and the Improvement of Cardiovascular Health

Full text available.

Ideal cardiovascular health in Chinese urban population

BackgroundThe American Heart Association's 2020 Strategic Goals define a new concept of cardiovascular health. However, the prevalence of ideal cardiovascular health outside of the United States is unclear, and its relationship with psychological status has not been reported. MethodWe included 9962 participants (mean age 47.1years; 44.2% women) from the survey of the Disease Risk Evaluation and Health Management study from October 2009 to Feb 2012. The prevalence of poor, intermediate, and ideal cardiovascular health levels were calculated, and psychological status was assessed using the 21-item Depression Anxiety Stress Scales. ResultsAfter adjusting for sex and age, only 0.5% of the participants met ideal levels of all 7 cardiovascular health metrics, and 26.9% presented with 5 to 7 ideal health metrics. Fasting plasma glucose was the most prevalent ideal metric (71.2%), whereas physical activity was the least prevalent (18.1%). Women had a significantly higher proportion of 5 to 7 ideal health metrics compared with men (40.4% versus 13.4% after adjusting for age), and the proportion of participants who had 5 to 7 ideal health metrics significantly decreased with age (P<0.001 for trend). Furthermore, the scores for depression, anxiety, and stress showed a negative correlation with the number of ideal health metrics, with regression coefficients of −0.07, −0.07, and −0.11, respectively (P<0.05). ConclusionsFew adults met ideal levels of cardiovascular health. Individuals, communities, and health-care providers in China should be better integrated to pay closer attention to primordial prevention of unhealthy lifestyles and psychological problems.

Abstract 9760: Population-Level Cardiovascular Health Behavior and Health Factor Trends (1988-2008) and Projections to 2020 in US Men and Women: Results from the National Health and Nutrition Examination Surveys (NHANES)

Introduction: The AHA 2020 Impact Goals recently defined 4 health behaviors (smoking, body mass index [BMI], diet, and physical activity) and 3 health factors (cholesterol, blood pressure, and plasma glucose) that serve as population-level metrics for evaluating cardiovascular (CV) health. However, there have been no forward projections of population trends of these metrics to 2020. Methods: We used data from cardiovascular disease-free individuals from NHANES III (1988-1994) and recent 2-year cycles (1999-2000, 2001-2, 2003-4, 2005-6, 2007-8) to provide population-level, sex-specific trends in prevalence of poor, intermediate and ideal levels of CV health behavior/factors. We also performed age-adjusted forward projections to 2020 using weighted linear regression coefficients. Results: The Table describes prevalence of poor, intermediate and ideal CV health behavior/factor levels from 1988-2008, weighted linear regression coefficients β (SE), and 2020 projections for men. Favorable trends from 1988-2008 included declines in prevalence of current and former smoking, hypercholesterolemia, and hypertension. In contrast, there were adverse trends in BMI, and dysglycemia. Prevalence of physical activity levels and remarkably low diet quality scores showed minimal changes over time. Women had generally similar trends in CV health profiles. Projections to 2020 suggest that obesity and impaired fasting glucose/diabetes could increase to affect more than 45% and 75% of US men, respectively, and 42% and 55% of US women. Conclusions: Improvements in prevalence of smoking, hypercholesterolemia and hypertension since 1988 have been offset by increases in adiposity and dysglycemia in US men and women. If current trends in obesity and dysglycemia are not reversed rapidly (likely through improvements in diet and physical activity), achievement of the 2020 Strategic Impact Goals will be difficult.