Mean Cardiovascular Health Score Research Articles

Prevalence and Determinants of Ideal Cardiovascular Health in Kenya: A Cross-Sectional Study Using Data From the 2015 Kenya STEPwise Survey.

Kenya is experiencing a rising burden of cardiovascular diseases (CVDs) due to epidemiological and demographic shifts, along with increasing risk factors. Ideal cardiovascular health (iCVH), defined by the American Heart Association (AHA), encompasses eight metrics to evaluate cardiovascular well-being. This study assessed the prevalence and determinants of iCVH in Kenya. Data from the 2015 Kenya STEPwise survey on non-communicable disease risk factors, including 4,500 adults aged 18-69, were analysed. iCVH was assessed using 2022 AHA criteria based on seven factors: nicotine exposure, physical activity, diet, BMI, blood pressure, glucose, and lipid levels. A cardiovascular health (CVH) CVH score of ≥80% classified individuals as having iCVH. Multivariable binary and ordinal logistic regression identified factors associated with iCVH. The mean CVH score in Kenya was 78.6% (95% CI: 77.9,79.2%), higher in females (79.3%), rural areas (79.5%), and non-drinkers (79.6%) than in males (77.9%), urban residents (77.0%), and alcohol drinkers (75.4%), respectively. The prevalence of iCVH (CVH score ≥80%) was 45.6%, while 6.4% had poor CVH (CVH score <50%). Only 1.2% achieved the maximum CVH score. iCVH prevalence declined with age and was lower among married individuals (43.7%), alcohol drinkers (32.3%), and urban residents (39.7%). Older adults had 50-80% lower odds of iCVH compared to those under 30 years. Alcohol users (AOR 0.5; p < 0.001) and urban residents (AOR 0.6; p < 0.001) were less likely to have iCVH. Residents of Nairobi and Central regions had 40-60% lower odds of iCVH compared to those in Rift Valley. The Kalenjin (AOR 0.5; p = 0.027) and Turkana (AOR 0.3; p = 0.002) ethnic groups had lower odds of iCVH compared to the Kisii. Less than half of Kenyan adults have iCVH, with poorer CVH status among older adults, urban residents, and alcohol users. Targeted public health interventions could mitigate the CVD burden and enhance health outcomes in Kenya.

Greater Adherence to Life's Essential 8 for Cardiovascular Health Is Associated With Lower Arterial Stiffness in Survivors of Cancer.

Survivors of cancer have elevated risk of cardiovascular disease, likely stemming from the negative impact of anticancer therapies on vascular function. Arterial stiffness is a strong indicator of vascular function and independent predictor of cardiovascular disease. The American Heart Association recommends Life's Essential 8 for optimal cardiovascular health. It is currently unknown, however, whether greater adherence to Life's Essential 8 is associated with low arterial stiffness in survivors of cancer. This cross-sectional study included 172 older adult (≥65 years) survivors of cancer (74±6 years; 58% female). Life's Essential 8 100-point cardiovascular health score, with higher scores indicative of better cardiovascular health, was calculated based on 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Participants were classified as having low (<60), moderate (60-79), or high (≥80) cardiovascular health. Pulse wave velocity (PWV) was used to assess arterial stiffness; with high arterial stiffness defined as a pulse wave velocity ≥10 m/s. The mean cardiovascular health score was 72±11 and 40 survivors (23%) had high arterial stiffness. Compared with low cardiovascular health, the odds ratio of high arterial stiffness was 0.12 (95% CI, 0.03-0.50) and 0.02 (95% CI, 0.003-0.18) for moderate and high cardiovascular health, respectively. Every 10-point increase in the cardiovascular health score was associated with a 0.43 m/s reduction in pulse wave velocity (P<0.001). Greater adherence to the American Heart Association's Life's Essential 8 was associated with lower prevalence of high arterial stiffness in older adult survivors of cancer. Prospective studies with larger samples are needed.

Factors Associated With the Cardiovascular Health of Black and Latino Adults With Type 2 Diabetes.

The purpose of this study was to assess the levels of cardiovascular health (CVH) of Black and Latino adults with type 2 diabetes (T2D) and examine the association of individual and microsystem level factors with their CVH score. This was a cross-sectional design in 60 Black and Latino Adults aged 18-40 with T2D. Data were collected on sociodemographic, individual (sociodemographic, diabetes self-management, sleep disturbance, depressive symptoms, quality of life, and the inflammatory biomarkers IL-6 and hs-CRP) and microsystem factors (family functioning), and American Heart Association's Life's Simple 7 metrics of CVH. Factors significantly associated with the CVH score in the bivariate analyses were entered into a linear regression model. The sample had a mean age 34 ± 5years and was primarily female (75%) with a mean CVH score was 8.6 ± 2.2 (possible range of 0-14). The sample achieved these CVH factors at ideal levels: body mass index <25kg/m2 (8%); blood pressure <120/80 (42%); hemoglobin A1c < 7% (57%); total cholesterol <200mg/dL (83%); healthy diet (18%); never or former smoker > one year (95%); and physical activity (150 moderate-to-vigorous minutes/week; 45%). In the multivariable model, two factors were significantly associated with cardiovascular health: hs-CRP (B = -0.11621, p < .0001) and the general health scale (B = 0.45127, p = .0013). This sample had an intermediate level of CVH, with inflammation and general health associated with overall CVH score.

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.

Validation of "Life's Essential 8" Metrics With Cardiovascular Structural Status in Children: The PROC Study in China.

Background Life's Essential 8 (LE8) metrics for cardiovascular health (CVH) aid primordial prevention in US populations. Methods and Results We conducted a child cohort study (PROC [Beijing Child Growth and Health Cohort]) with baseline (2018-2019) and follow-up (2020-2021) assessments, enrolling disease-free 6- to 10-year-old children from 6 elementary schools in Beijing. We collected LE8-assessed components via questionnaire surveys and 3 cardiovascular structural parameters by 2-dimensional M-mode echocardiography: left ventricular mass (LVM), LVM index, and carotid intima-media thickness. Compared with 1914 participants (mean age, 6.6 years) at baseline, we saw lower mean CVH scores at follow-up (n=1789; 8.5 years). Among LE8 components, diet presented the lowest perfect-score prevalence (5.1%). Only 18.6% of participants had physical activity ≥420 min/wk, 55.9% had nicotine exposure, and 25.2% had abnormal sleep duration. Prevalence of overweight/obesity was 26.8% at baseline and 38.2% at follow-up. We noted optimal blood lipid scores in 30.7%, while 12.9% of children had abnormal fasting glucose. Normal BP was 71.6% at baseline and 60.3% at follow-up. LVM (g), LVM index (g/m2.7), and carotid intima-media thickness (mm) were significantly lower in children with high (56.8, 33.2, 0.35) or moderate CVH scores (60.6, 34.6, 0.36), compared with children with low CVH scores (67.9, 37.1, 0.37). Adjusting for age/sex, LVM (β=11.8 [95% CI, 3.5-20.0]; P=0.005), LVM index (β=4.4 [95% CI, 0.5-8.3]; P=0.027), and carotid intima-media thickness (β=0.016 [95% CI, 0.002-0.030]; P=0.028) were higher in the low-CVH group. Conclusions CVH scores were suboptimal, declining with age. LE8 metrics indicated worse CVH in children with abnormal cardiovascular structural measurements, suggesting the validity of LE8 in assessing child CVH. Registration URL: https://www.chictr.org.cn/index.html; Unique identifier: ChiCTR2100044027.

Change in cardiovascular health among adults with current or past major depressive disorder enrolled in intensive smoking cessation treatment

BackgroundElevated depressive symptoms and cigarette smoking are independently associated with poorer cardiovascular health (CVH), but it is unknown whether their treatment can synergistically improve CVH. We sought to characterize CVH of adults with comorbid depression and smoking and examine changes in CVH associated with changes in smoking and depression. MethodsParticipants (N = 300, 55 % women) were adult smokers (≥ 1 cigarette/day) with lifetime major depressive disorder enrolled in a 12-week intervention trial targeting depression and smoking. Multiple linear regression examined prospective associations between changes in depression (Beck Depression Inventory-II), smoking (past 24-hour cigarettes or smoking abstinence), and modified CVH score (per American Heart Association, excluding smoking: diet, physical activity, body mass index, blood glucose, cholesterol, blood pressure). ResultsBaseline mean CVH score was 5.87/12 points (SD = 2.13). No participants met “ideal” on all CVH components (blood glucose: 48 %, cholesterol: 46 %, physical activity: 38 %, body mass index: 24 %, blood pressure: 22 %, diet: 3 %). CVH scores did not change from baseline to end-of-treatment (M = 0.18 points, SD = 1.36, p = .177), nor did change in depression × smoking predict change in CVH (p = .978). However, greater reductions in depression were significantly associated with greater improvements in CVH (β = −0.04, SE = 0.01, p = .015). LimitationsThis study was limited by a short follow-up period, missing blood glucose and cholesterol data, and treatment-seeking smokers. ConclusionsAdults with comorbid depression and smoking had poor CVH. Although integrated treatment for depression and smoking improved both conditions, only reductions in depression were associated with improvements in CVH. These findings have implications for integrating psychosocial treatment into CVH promotion efforts. RegistrationNCT02378714 (clinicaltrials.gov).

Abstract P360: Social and Psychosocial Determinants of Racial and Ethnic Differences in Cardiovascular Health: The MESA and MASALA Studies

Background: Social and psychosocial factors are associated with cardiovascular health (CVH) and may underlie race/ethnic differences in CVH. Quantifying the contribution of individual-level social and psychosocial factors to racial and ethnic differences in CVH may guide strategies to reduce disparities. Methods: In the MESA and MASALA cohorts, Kitagawa-Blinder-Oaxaca decomposition quantified the contributions of social and psychosocial factors to differences in mean CVH score (range 0-14, with 14 indicating optimal CVH) in Black, Chinese, Hispanic, or South Asian compared with White participants. Results: Among 7,978 adults (mean age 61 [SE 10] years, 52% female), there were 1,892 Black (mean CVH score 7.96), 804 Chinese (CVH 9.69), 1,496 Hispanic (CVH 8.00), 1,164 South Asian (CVH 9.16), and 2,622 White (CVH 8.91) participants. The factors that statistically contributed the most to explained differences in mean CVH score were income for Black participants (if mean income in Black participants were equivalent to White participants, Black participants’ mean CVH score would be 0.14 points higher, p&lt;0.05); place of birth for Chinese participants (if proportion of US-born and foreign-born individuals among Chinese adults were equivalent to White participants, Chinese participants’ mean CVH score would be 0.22 points lower, p&lt;0.05); and education for Hispanic and South Asian participants (if educational attainment were equivalent to White participants, Hispanic and South Asian participants’ mean CVH score would be 0.55 points higher and 0.37 points lower, respectively, p&lt;0.05 for both). Conclusions: In this multiethnic US cohort, social and psychosocial factors statistically explained racial and ethnic differences in CVH. Socioeconomic and immigration-related factors contributed the largest magnitude to CVH differences between race and ethnic groups.

Abstract 39: Association of Cardiovascular Health With Time Lived Free of Coronary Artery Calcium

Introduction: Zero coronary artery calcium (CAC) is associated with lower risk of cardiovascular disease. More time lived without CAC may delay coronary artery disease morbidity, but prediction of when CAC will first develop is not well understood. To inform cardiovascular prevention, we evaluated how cardiovascular health (CVH) relates to time lived without CAC. Methods: In Multi-Ethnic Study of Atherosclerosis (MESA) participants with zero CAC at baseline followed up to 10 years, we used Kaplan-Meier curves to estimate restricted mean survival time since study entry lived with zero CAC, by baseline CVH per Life’s Simple 7 metrics categorized as high (score 12-14), moderate (8-11), and low (0-7), and stratified by sex and age (45-64, 65-84 years). Results: Among 3416 participants without CAC at baseline (63% female, mean age 58 [SD 9] years, mean CVH score 8.8 [2.1]), mean years lived with zero CAC was 4.9 (SD 3.5) years. Women with high CVH lived on average 6.6 (95% CI 6.4-6.8) years with zero CAC, with moderate CVH 6.2 (6.1-6.3) years with zero CAC, and with low CVH 5.6 (5.3-5.8) years with zero CAC. Men with high CVH lived on average 6.4 (5.9-6.9) years with zero CAC, with moderate CVH 6.1 (5.9-6.3) years with zero CAC, and with low CVH 5.5 (5.1-5.9) years with zero CAC (Figure A). Among participants aged 45-64 years, those with high CVH lived on average 7.4 (7.1-7.6) years with zero CAC, with moderate CVH 6.8 (6.6-6.9) years with zero CAC, and with low CVH 5.9 (5.7-6.2) years with zero CAC. Among participants aged 65-84 years, those with high CVH lived on average 5.1 (4.5-5.7) years with zero CAC, with moderate CVH 5.2 (5.0-5.4) years with zero CAC, and with low CVH 4.9 (4.6-5.2) years with zero CAC (Figure B). Conclusions: High CVH was associated with longer time lived with zero CAC in women and men. Adults aged 45-64 years with high or intermediate CVH at baseline had longer time lived with zero CAC compared with those with low CVH. Older adults had no difference in time lived with zero CAC based on CVH. Maintaining CVH in midlife may delay onset of CAC.

Abstract MP78: Race/Ethnic Disparities in Children’s Cardiovascular Health: The Role of Social Disadvantage in Early Life

Introduction: The loss of cardiovascular health (CVH) begins early in life and disproportionately affects racial/ethnic minorities, particularly children in single parent households, and households with lower education, family income and food insecurity. However, the contribution of these social determinants to CVH disparities in childhood are poorly understood. Hypothesis: We hypothesized that racial/ethnic differences in CVH among US children are explained by social disadvantages. Methods: Data from the 2013-2018 National Health and Nutrition Examination Survey for children aged 2-18 (N=4,792) were used. CVH was measured using the AHA Life’s Essential 8 scores that combine nicotine exposure, diet, physical activity, sleep, body mass index, and blood pressure, lipids, and glucose. Oaxaca-Blinder decomposition methods were used to quantify the contributions of parental education, marital status and household income to poverty ratio, and food security to differences in CVH by race and sex. Results: Mean CVH score was highest among non-Hispanic White (mean [SE] = 73.7 [0.5]) than non-Hispanic Black (71.3 [0.6]) and Hispanic children (71.0 [0.4]). There was no significant difference among Black-White boys (mean differences [MD] = -1.52; 95% CI: -3.25, 0.21). Black girls had significantly lower CVH than White girls (MD= -2.66; 95% CI: -4.40, -0.91). Differences in parental college education accounted for 46% of the differences in CVH scores (MD = -1.21; 95% CI: -1.89, -0.54). Among Hispanic children, both boys (MD = -2.47; 95% CI: -4.22, -0.73) and girls (MD = -3.09; 95% CI: -4.60, -1.58) had significantly lower CVH scores than White boys and girls, respectively. Differences in parental education explained 66% of the difference in CVH among White-Hispanic boys and girls (MD= -0.66; 95%CI-1.11, -0.20; and MD= -0.66; 95%CI-1.20, -0.13). Discussion: Differences in parental college education largely explained lower levels of CVH among US Black and Hispanic children, a predictor of future cardiovascular disease.

Abstract P315: Depressive Symptoms and Cardiovascular Health Among Young Adults in Puerto Rico

Background: Depressive symptoms are associated with cardiovascular disease (CVD) incidence, morbidity and mortality. Less is known about the association between depressive symptoms and overall cardiovascular health (CVH) of young adults, an age group that commonly experiences depressive symptoms. We examined the association between depressive symptoms and a metric of overall CVH among young Puerto Ricans, a high risk but understudied population. Measures: We used data from PR-OUTLOOK, a study of CVH among individuals aged 18-29 residing in Puerto Rico, obtained between September 2020 and September 2022. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). CVH was assessed using the AHA Life’s Essential 8 metric, which includes modifiable behavioral (nicotine exposure, diet, physical activity, sleep health) and biological (body mass index- BMI, blood lipids, blood pressure, and blood glucose) components. For this analysis, this metric was modified to exclude diet. Higher scores (range 0-100), overall and for each component, indicate better CVH. Covariates included age, sex, marital status, and childhood material deprivation. Multivariable linear regression models were used to assess the relationships of CES-D-10 score with overall CVH score and its individual components. An interaction term for sex and CES-D-10 was added to the models to examine potential differences by sex. Results: The sample (n=964; mean age: 22.6 ±3.1) was largely female (64%) and single (89%), and a third (33%) reported having experienced material deprivation in childhood. Over half (58.6%) reported depressive symptoms above the cut-off for likely clinical depression (CES-D-10 &gt;10). The overall mean CVH score was 80.2±12.8, with almost half of the sample (42.8%) having a score &lt; 80. Mean scores for the CVH components were lowest for physical activity (57.2±43.2) and BMI (71.4±33.9). In adjusted models, significant inverse associations were observed between CES-D-10 with overall CVH (-4.21, 95%CI: -5.84,-2.58) and several CVH components: nicotine exposure (-4.28; 95%CI: -8.28,-0.28), physical activity (-9.32; 95%CI: -14.87,-3.78), BMI (-6.54; 95%CI: -10.94,-2.15), and blood pressure (-3.02; 95%CI: -5.81,-0.23). No significant interaction was observed between CES-D-10 and sex. Conclusion: Depressive symptoms were inversely associated with CVH and four of the seven assessed CVH components. Longitudinal analyses should elucidate the potential contribution of depressive symptoms to reduction in CVH in young adults. Understanding factors associated with CVH among young Puerto Ricans may help elucidate CVD prevention targets for this vulnerable population.

Spousal concordance of ideal cardiovascular health metrics: findings from the 2014–2019 Korea National Health and Nutrition Examination Survey

BackgroundsWe aimed to investigate whether a spouse’s cardiovascular health (CVH) metrics status affects the other spouse’s ideal CVH using a Korea nationwide representative survey.MethodsWe used the health data of 6,030 married couples who participated in the Korea National Health and Nutrition Examination Survey from 2014 to 2019. The CVH was defined using seven metrics: smoking status, blood pressure, body mass index, total cholesterol, fasting blood glucose, physical activity, and diet, following the American Heart Association guidelines and modifications for body mass index cutoffs and diet quality. The CVH score was calculated on a scale ranging from 0 to 7, with the ideal CVH defined as attaining ideal scores in at least five CVH metrics. Multiple logistic regression analyses were used to assess whether husband’s ideal CVH was associated with his wife’s odds for having ideal CVH, and vice versa.ResultsThe mean CVH scores were 3.2 and 4.0 for husband and wife, respectively. After fully adjusting for age and education of both partners and household income, husbands had 1.49 times (95% confidence interval [CI], 1.27–1.69) higher odds of achieving ideal CVH if their wives had also achieved ideal CVH. Meanwhile, wives whose husbands achieved ideal CVH also had 1.46 times (95% CI, 1.27–1.69) higher odds of achieving ideal CVH. Nonsmoking (57.17%), ideal fasting blood glucose level (34.93%), and ideal diet intake (24.18%) were the most concordant CVH metrics among spouses.ConclusionsOur study found a significant spousal concordance of ideal CVH in Korean married couples. This finding supports the use of a couple-based interventional strategy targeted to promote CVH.

Abstract 12235: Contribution of Individual-Level Factors to Racial and Ethnic Differences in Cardiovascular Health in the United States Population

Introduction: Individual-level factors across several domains underlie racial and ethnic differences in cardiovascular health (CVH). Quantifying the contributions of these determinants to racial and ethnic differences in CVH may inform targeted strategies to mitigate inequities. Methods: In data from NHANES 2011-2018, we calculated mean CVH score (range 0-14; defined by AHA’s Life’s Simple 7 metrics) among US adults ≥20 years. We applied Kitagawa-Blinder-Oaxaca decomposition to quantify the contributions of education, income, food security, marital status, health insurance, place of birth (US vs. foreign born), and depression to racial and ethnic differences in CVH. Results: Among 16,172 participants representing 255 million US adults, 41% were non-Hispanic (NH) White, 23% NH Black, 24% Hispanic, and 12% NH Asian. Among males, mean (SE) CVH score was 7.58 (2.3) in NH White, 7.48 (2.4) in NH Black, 7.45 (2.3) in Hispanic, and 8.71 (2.2) in NH Asian adults. Education explained the largest component of CVH differences in males (if education were similar to NH White, CVH score would be 0.23 [0.03] points higher in NH Black, 0.36 [0.04] points higher in Hispanic, and 0.24 [0.04] points lower in NH Asian, p&lt;0.05; Figure A). Among females, mean (SE) CVH score was 8.00 (2.5) in NH White, 7.43 (2.3) in NH Black, 8.03 (2.4) in Hispanic, and 9.34 (2.1) in NH Asian adults. Education explained the largest component of CVH difference in NH Black females (if education were similar to NH White, CVH score would be 0.17 [0.03] points higher in NH Black, p&lt;0.05; Figure B). Place of birth explained the largest component of CVH difference in Hispanic and NH Asian females (if place of birth were similar to NH White, CVH score would be 0.36 [0.07] points lower and 0.49 [0.16] points lower, respectively, p&lt;0.05). Conclusion: Education and place of birth confer the largest contributions to the net difference in mean CVH score among racial and ethnic groups in the US.

Abstract 11843: Association of Individual- And Neighborhood-Level Factors With Racial and Ethnic Differences in Cardiovascular Health During Early Pregnancy

Introduction: Individual and neighborhood-level factors are associated with racial and ethnic differences in cardiovascular health (CVH). To identify strategies to improve maternal health, we determined the relative contributions of these factors to racial and ethnic differences in early pregnancy CVH. Methods: We included pregnant individuals from nuMoM2b, a multicenter cohort who self-identified as Hispanic, non-Hispanic Black (NHB), or non-Hispanic White (NHW). We applied a Blinder-Oaxaca decomposition to evaluate the extent to which socioeconomic and psychosocial factors, discrimination experiences, and area deprivation index statistically explain racial and ethnic differences in CVH (0-8 points, based on body mass index, blood pressure, diabetes, and smoking status) in the first trimester. This method utilizes a counterfactual approach to estimate the mean change in CVH in the Hispanic and NHB groups if covariates were set to the mean in the referent group (NHW). We calculated the percent explained by each factor by dividing the predicted mean change by the total CVH difference between groups*100. Results: Of 5,695 pregnant individuals, 12.3% were Hispanic, 8.9% NHB and 78.8% NHW. Mean CVH scores were 6.4 for Hispanic, 6.0 for NHB and 6.6 for NHB individuals. After adjusting for age and immigrant status, mean CVH scores were lower (worse) by 0.83 (95% CI 0.51-1.04) points in NHB individuals and 0.49 (95% CI 0.28-0.60) points in Hispanic individuals compared with NHW individuals. Differences in social and psychologic factors explained 87% of NHB-NHW differences and 71% of Hispanic-NHW differences in CVH scores (FIGURE) ; socioeconomic factors explained the greatest difference in CVH between groups. Conclusions: Individual- and neighborhood-level social and psychologic factors statistically explained a clinically meaningful difference in CVH among racial and ethnic groups, which may inform strategies to optimize health in pregnant individuals.

Social and Psychosocial Determinants of Racial and Ethnic Differences in Cardiovascular Health in the United States Population.

Social and psychosocial factors are associated with cardiovascular health (CVH). Our objective was to examine the contributions of individual-level social and psychosocial factors to racial and ethnic differences in population CVH in the NHANES (National Health and Nutrition Examination Surveys) 2011 to 2018, to inform strategies to mitigate CVH inequities. In NHANES participants ages ≥20 years, Kitagawa-Blinder-Oaxaca decomposition estimated the statistical contribution of individual-level factors (education, income, food security, marital status, health insurance, place of birth, depression) to racial and ethnic differences in population mean CVH score (range, 0-14, accounting for diet, smoking, physical activity, body mass index, blood pressure, cholesterol, blood glucose) among Hispanic, non-Hispanic Asian, or non-Hispanic Black adults compared with non-Hispanic White adults. Among 16 172 participants (representing 255 million US adults), 24% were Hispanic, 12% non-Hispanic Asian, 23% non-Hispanic Black, and 41% non-Hispanic White. Among men, mean (SE) CVH score was 7.45 (2.3) in Hispanic, 8.71 (2.2) in non-Hispanic Asian, 7.48 (2.4) in non-Hispanic Black, and 7.58 (2.3) in non-Hispanic White adults. In Kitagawa-Blinder-Oaxaca decomposition, education explained the largest component of CVH differences among men (if distribution of education were similar to non-Hispanic White participants, CVH score would be 0.36 [0.04] points higher in Hispanic, 0.24 [0.04] points lower in non-Hispanic Asian, and 0.23 [0.03] points higher in non-Hispanic Black participants; P<0.05). Among women, mean (SE) CVH score was 8.03 (2.4) in Hispanic, 9.34 (2.1) in non-Hispanic Asian, 7.43 (2.3) in non-Hispanic Black, and 8.00 (2.5) in non-Hispanic White adults. Education explained the largest component of CVH difference in non-Hispanic Black women (if distribution of education were similar to non-Hispanic White participants, CVH score would be 0.17 [0.03] points higher in non-Hispanic Black participants; P<0.05). Place of birth (born in the United States versus born outside the United States) explained the largest component of CVH difference in Hispanic and non-Hispanic Asian women (if distribution of place of birth were similar to non-Hispanic White participants, CVH score would be 0.36 [0.07] points lower and 0.49 [0.16] points lower, respectively; P<0.05). Education and place of birth confer the largest statistical contributions to the racial and ethnic differences in mean CVH score among US adults.

Association of sarcopenia with ideal cardiovascular health metrics among US adults: a cross-sectional study of NHANES data from 2011 to 2018

ObjectiveThe American Heart Association (AHA) proposed the concept of ideal cardiovascular health (CVH) to reduce the risk of cardiovascular mortality. We attempted to broaden the impact of CVH and further...

Association between sleep duration and ideal cardiovascular health in Chinese adults: results from the China health and nutrition survey.

Ideal cardiovascular health (CVH) is related to the future risk of cardiovascular disease. Sleep duration is an important factor influencing health outcomes. The association between sleep duration and CVH is unclear. We aimed to explore the associations between sleep duration and CVH among Chinese adults. This cross-sectional study was based on nationally representative samples from 2009 China Health and Nutrition Survey (CHNS). Sleep duration was categorized as ≤6, 7, 8, and ≥9 h. The CVH scores were evaluated. Generalized linear regressions and restricted cubic splines were used to determine the association between sleep duration and CVH. A total of 8,103 Chinese adults with a mean age of 50.29 (14.97) years were included. The mean (SD) CVH score was 3.96 (1.43). Only 36.7% of the participants had ideal CVH. Sleep duration was positively associated with ideal CVH (P-trend < 0.05). When comparing the long sleep duration with the short sleep duration, short sleep duration significantly decreased the mean CVH score, β = -0.24 (95% CI: -0.36, -0.13) and increased the risk of nonideal CVH, OR = 1.38 (95% CI: 1.15, 1.67) by generalized linear regressions. The restricted cubic splines showed CVH did not have a significant nonlinear relationship with sleep duration. The P-value for nonlinear was 0.161. The association of sleep duration with CVH had no obvious threshold. Short sleep duration was associated with decreased odds of ideal CVH and lower mean CVH score. Confirmation through longitudinal studies is needed.

Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates From the National Health and Nutrition Examination Survey (NHANES), 2013 Through 2018.

The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score. We included individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race and ethnicity, family income, and depression. There were 23 409 participants, representing 201 728 000 adults and 74 435 000 children. The overall mean CVH score was 64.7 (95% CI, 63.9-65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2-68.7), and racial and ethnic group (range, 59.7-68.5). Mean scores were lowest for diet, physical activity, and body mass index metrics. There were large differences in mean scores across demographic groups for diet (range, 23.8-47.7), nicotine exposure (range, 63.1-85.0), blood glucose (range, 65.7-88.1), and blood pressure (range, 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1-88.3) and body mass index (range, 74.4-89.4) scores by sociodemographic group. The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in individuals and the population.

Abstract EP54: Ideal Cardiovascular Health Metrics: Are They Just Cardiovascular Protective Factors?

Background: The American Heart Association (AHA) proposed the concept of ideal cardiovascular health (CVH) to reduce the risk of cardiovascular mortality. However, the overall CVH status is still unsatisfactory. We attempted to contribute to AHA 2030 goals by identifying the relationship between CVH and non-cardiovascular diseases such as sarcopenia. Methods: We analyzed data on 3311 adults &gt; 20 years of age from the NHANES 2011-2018. Sarcopenia was defined as the lowest for gender-specific sarcopenia index cut-off values. CVH was categorized as inadequate, average, or optimum. We used multinomial logistic regression to assess the association between CVH and sarcopenia. Results: This cohort study involving 3,311 adults &gt; 20 years comprised 1329 females (42.4%). The number of intermediate or ideal and poor CVH participants was 1719 and 1592 with mean CVH score of 9.3 ± 0.1 and 5.43 ± 0.1, respectively. After adjusting for related confounding factors, intermediate or ideal CVH was associated with a risk reduction of sarcopenia than poor CVH (aOR: 0.39, 95% CI; 0.22-0.69, P &lt; 0.001) and the risk of sarcopenia was significantly lower for each incremental increase of 1 in CVH metrics (aOR: 0.76, 95% CI: 0.70-0.83, P &lt; 0.001). Moreover, if the number of ideal CVH metrics was &gt; 5, the risk of sarcopenia decreased by up to 85% (aOR: 0.15, 95% CI: 0.06-0.38, P &lt; 0.05). Conclusions: Our findings suggest a relationship between the CVH and the prevalence of sarcopenia in adults. Our analysis confirms that CVH extends beyond protection against cardiovascular disease. The results of our study can contribute to achieving the 2030 public health goal of achieving CVH for all, which may be supported by efforts to reduce the prevalence of sarcopenia.

Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions.

This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.

Lifetime Trauma and Cardiovascular Health in Latinas.

Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care. The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women. Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0-24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life's Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0-14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support. The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3-10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance. Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.