Prevalence Of Cardiovascular Health Metrics Research Articles

Abstract MP45: Cardiovascular Health in Early Adulthood Predicts the Development of Coronary Artery Disease: 25 Year Follow Up in Individuals With Type 1 Diabetes From the Pittsburgh Epidemiology of Diabetes Complications Study

Introduction: Coronary artery disease (CAD) is especially burdensome among individuals with type 1 diabetes (TID). The AHA created metrics to monitor cardiovascular health (CVH) to promote primordial prevention. CVH metrics define 3 health behaviors (diet, physical activity, and smoking), and 4 health factors (BMI, total cholesterol, blood pressure and fasting glucose) as ideal, intermediate or poor based on set criteria. These CVH metrics have been shown to be related to cardiovascular outcomes in the general population. The purpose of this research is to describe the prevalence of CVH metrics in young adults with T1D, a group at particularly high risk for CAD , and assess the hypothesis that more favorable metrics protect against future hard CAD outcomes. Methods: Data are from the longitudinal Pittsburgh Epidemiology of Diabetes Complications (EDC) study. CVH metrics are defined by an average of measures taken at first visit and first follow up visit (1986-1990, “baseline”) for participants age ≥20 at study entry without prevalent CAD. CVH metrics were scored according to AHA criteria, with HbA1c in place of fasting glucose. Total CVH score (possible range 0-14) is the sum of subscores for each metric where poor=0, intermediate=1 and ideal=2. Cox proportional hazards models were used to assess the association between baseline CVH and CAD incidence during 25 years of follow-up. Results: Characteristics of the 463 individuals analyzed after exclusions (179 age <20 or prevalent CAD, 15 missing data) are shown in Table 1. No participants achieved ideal status for all 7 CVH metrics. Each unit increase in ideal CVH score was associated with 28% lower risk (95% CI: 0.63-0.82, p<0.01), while each unit increase in total CVH score was associated with 23% lower risk of CAD (95% CI: 0.71-0.84, p<0.01), adjusting for baseline diabetes duration, sex, race, albumin excretion rate, and triglycerides. Conclusions: CVH metric scores appear to be predictive of CAD in adults with T1D, demonstrating the value of promoting ideal CVH for CAD prevention.

Cardiovascular health metrics among South Asian adults in the United States: Prevalence and associations with subclinical atherosclerosis

South Asians, a fast growing ethnic group in the US, have an increased risk for cardiovascular disease compared to the general population. We examined the prevalence and distribution of the American Heart Association's Life's Simple 7 cardiovascular health (CVH) metrics using data from Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, and cross-sectional associations between number of CVH metrics in the ideal range with subclinical atherosclerosis assessed using coronary artery calcium (CAC) measured using cardiac computed tomography and carotid intima media thickness (CIMT) measured using high-resolution B-mode ultrasonography. CAC was modeled as Agatston scores=0, 1–400 and >400; CIMT was examined continuously and as internal CIMT>1.5mm. In the MASALA cohort (N=875; mean age: 55years; 53% men; living in greater San Francisco and Chicago areas; October 2010–March 2013) without prevalent coronary heart disease, no participant had all 7 metrics in ideal range; approximately 20% of the participants had at least 5 metrics in ideal range. Higher number of CVH metrics in the ideal range was inversely associated with subclinical atherosclerosis. A 1 unit increase in the number of CVH metrics in the ideal range was associated with 32% lower odds of CAC=1–400 (vs. CAC=0; OR=0.68, 95% CI: 0.60, 0.78) and 28% lower odds of internal CIMT>1.5mm (OR=72, 95% CI: 0.61, 0.85). These data show the prevalence of CVH metrics among South Asians in the US, and provide empirical evidence on inverse associations of meeting ideal levels for higher number of metrics and subclinical atherosclerosis.

Sex inequalities in cardiovascular health: a cross-sectional study.

The aim of this study was to determine sex differences in the prevalence of cardiovascular health (CVH) metrics according to the CVH status. The cross-sectional, population-based study involved 2250 women and 1920 men aged ≥18 years that participated in the 2010 National Health Survey in the Republic of Srpska, Bosnia and Herzegovina. Prevalence of CVH behaviours (smoking, body mass index, physical activity, diet), CVH factors (cholesterol, fasting blood glucose and blood pressure, plus smoking) and ideal CVH were estimated according to the American Heart Association criteria for ideal, intermediate and poor levels. Association between sex and ideal CVH categories was analyzed with multivariable logistic regression analysis across three age stratums. A higher prevalence of ideal CVH metrics was seen in women for smoking status, body mass index, healthy diet score and blood pressure, and in men for physical activity and total cholesterol. Women from all age groups had better CVH behaviours (odds ratio [OR] = 1.40 for the youngest; OR = 2.05 for middle-aged; and OR = 2.03 for older-aged women), while only women from the youngest age group had better CVH factors (OR = 5.09). In line with this, ideal overall CVH prevailed in younger and middle-aged women in comparison to men of the same ages (OR = 3.01 and OR = 2.25, respectively), while disappeared in older ones. Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention.

Abstract P114: Low Prevalence of Ideal Cardiovascular Health Metrics among African Americans: The Jackson Heart Study

Background: While the prevalence of cardiovascular health metrics or Life’s Simple Seven (LSS) has been shown to be far from optimal in the US, such information has been predominantly reported in Caucasians. The burden of cardiovascular disease among African Americans underscores the need to evaluate the prevalence and secular trends of LSS in other ethnic groups. Objective: To test the hypothesis that the prevalence of the LSS is far from ideal among participants of the Jackson Heart Study. Methods: We analyzed LSS with 3,500 African Americans from the Jackson Heart Study, using data from their first clinic visit (2000-2004). Standard methods were used to measure blood pressure, glucose, body mass index (BMI), and cholesterol. Information on physical activity, smoking, and diet was collected with interviewer-administered questionnaires. Each of the LSS metrics (smoking status, diet, physical activity, BMI, fasting blood glucose, total cholesterol, and blood pressure) was categorized as poor, intermediate, or ideal, as defined by the AHA guidelines. Results: The mean age at baseline was 56.9 ± 12.2 years and 2,350 participants (67%) were women. Among men, the prevalence of having 0, 1, 2, 3, 4, 5, 6, and 7 ideal cardiovascular health metrics was 6.6%, 25.8%, 32.7%, 21.6%, 10.6%, 2.3%, 0.4%, and 0%, respectively. Corresponding values for women were 3.2%, 28.1%, 32.9%, 22.3%, 10.1%, 2.9%, 0.38%, and 0%. While about two-thirds of men and women reported ideal smoking status, almost none reported ideal diet quality, and few met recommendations for BMI and blood pressure ( Figure) . Conclusions: Our data are consistent with less than optimal prevalence of cardiovascular health metrics in both men and women from the Jackson Heart Study. The lower prevalence of meeting ideal recommendations for diet, physical activity, BMI, and blood pressure underscores the need for targeted interventions to improve these modifiable lifestyle factors in order to reduce the burden of cardiovascular disease among African-Americans.

Racial Differences in Ideal Cardiovascular Health Metrics Among Mississippi Adults, 2009 Mississippi Behavioral Risk Factor Surveillance System

IntroductionCardiovascular disease is a leading cause of death and health disparities in Mississippi. Identifying populations with poor cardiovascular health may help direct interventions toward those populations disproportionately affected, which may ultimately increase cardiovascular health and decrease prominent disparities. Our objective was to assess racial differences in the prevalence of cardiovascular health metrics among Mississippi adults.MethodsWe used data from the 2009 Mississippi Behavioral Risk Factor Surveillance System to determine age-standardized prevalence estimates and 95% confidence intervals of cardiovascular health metrics among 2,003 black and 5,125 white adults. Logistic regression models were used to evaluate the relationship between race and cardiovascular health metrics. The mean cardiovascular metrics score and percentage of the population with ideal and poor cardiovascular health were calculated by subgroup.ResultsApproximately 1.3% of blacks and 2.6% of whites exhibited ideal levels of all 7 cardiovascular health metrics. The prevalence of 4 of the 7 cardiovascular health metrics was significantly lower among the total population of blacks than among whites, including a normal body mass index (20.8% vs 32.3%, P < .001), no history of diabetes (85.1% vs 91.3%, P < .001), no history of hypertension (53.9% vs 67.9%, P < .001), and physical activity (52.8% vs 62.2%, P < .001). The logistic regression models revealed significant race-by-sex interactions; differences between blacks and whites for normal body mass index, no history of diabetes mellitus, and no current smoking were found among women but not among men.ConclusionCardiovascular health is poor among Mississippi adults overall, and racial differences exist.