Status Of Cardiovascular Health Research Articles

The association of ideal cardiovascular health and its change with subclinical atherosclerosis according to glucose status: A prospective cohort study.

An updated definition was developed to better evaluate cardiovascular health (CVH). We aimed to investigate whether optimal or improvement of six CVH metrics defined by new Life's Essential 8 (LE8) may counteract the risk of subclinical atherosclerosis among patients with hyperglycemia. We conducted a prospective analysis of 5225 participants without prior cardiovascular diseases, of whom 4768 had complete data on CVH change. Subjects with CVH scores of 0-49, 50-79, and 80-100 points were categorized as having low, moderate, or high CVH, respectively. Subclinical atherosclerosis was evaluated by brachial-ankle pulse wave velocity, pulse pressure and albuminuria, both separately and in combination. Of the 5225 participants, 1937 (37.1%) had normal glucose regulation, while 3288 (62.9%) had hyperglycemia. The multivariable-adjusted odds ratio (OR) for composite subclinical atherosclerosis was 2.34 (95% confidence interval [CI], 1.88-2.91), 1.43 (95% CI, 1.21-1.70), and 0.74 (95% CI, 0.46-1.18), for participants with hyperglycemia who had low, moderate, or high overall CVH scores, respectively, compared with participants with normal glucose regulation. In addition, compared with those with stable CVH and normal glucose regulation, participants who exhibited greater improvements in overall CVH from 2010 to 2014 had a reduced risk of composite subclinical atherosclerosis with an OR of 0.72 (95% CI, 0.53-0.98) for those with normal glucose regulation, and 1.13 (95% CI, 0.87-1.48) for those with hyperglycemia. The novel defined CVH using six metrics was inversely associated with subsequent risk of subclinical atherosclerosis. Both the status of CVH and its changes modified the relationship between hyperglycemia and subclinical atherosclerosis.

Longitudinal association between maternal cardiovascular health in pregnancy and child birth outcomes

The American Heart Association has updated its definition of cardiovascular health (CVH) with a new framework known as Life's Essential 8 (LE8). Although gestational CVH assessment has been recommended, its significance based on LE8 for birth outcomes is unknown. We thus evaluated the status of gestational CVH based on LE8 in 3036 pregnant women of the Shanghai Maternal-Child Pairs Cohort and the population of China Maternal Nutrition and Health Sciences Survey, and also examined the association between gestational CVH and child birth outcomes. We found that only a small proportion (12.84%) had high CVH, while 1.98% had low CVH in this cohort study. In adjusted models, a 10-point increase in the gestational CVH score, indicating a more favorable score, was associated with lower neonatal size such as birth weight (β: − 37.05 [95% confidence interval: − 52.93, − 21.16]), birth length (− 0.12[− 0.22, − 0.01]), weight-for-height z-score (− 0.07[− 0.12, − 0.03]), body mass index z-score (− 0.09 [− 0.13, − 0.04]), length-for-age Z-score (− 0.03 [− 0.06, − 0.01]), and weight-for-age z-score (− 0.08 [− 0.12, − 0.05]). Also, a 10-point increase in the gestational CVH score was associated with the lower risk of large for gestational age (LGA) (0.82 [0.73, 0.92]) and macrosomia infant (0.75 [0.64, 0.88]). CVH categories showed similar results. That is, better maternal CVH status in pregnancy was associated with lower neonatal size and lower risks for LGA and macrosomia in newborns.

Association of gestational cardiovascular health with infant neurodevelopment: A prospective study in Hefei of Anhui, China

We investigate the prospective the association of gestational cardiovascular health (CVH) with infant neurodevelopment, and whether such relation was mediated by cord blood metabolites. The data come from the prospective birth cohort study in Hefei of Anhui, China. A total of 1714 mother-infant pairs are included from March 2018 and June 2021. CVH was evaluated at 24 to 28 gestational weeks by the combination of five metrics: body mass index, blood pressure, total cholesterol, glucose, and smoking. Cord blood samples were collected at delivery for the detection of related indicators. Infant neurodevelopment at 12 months was assessed by the Ages and Stages Questionnaire Edition 3 (ASQ-3). We stratified the status of CVH into three levels, ideal, intermediate, and poor. Compared with the ideal CVH, poor CVH was associated with infant communication domain failure (RR = 2.06; 95 %CI, 1.24–3.42) and cord blood C-peptide levels (β = 0.09; 95 %CI, 0.06–0.13) were higher. Cord blood C-peptide level with infant communication domain failure risk increased (RR = 3.43, 95 %CI: 2.11–5.58). Mediation analysis showed that cord blood C-peptide mediated 13.9 % of the effect. Key findings indicated that maternal poor CVH at 24 to 28 weeks gestation was associated with an increased risk of infant neurodevelopment at ASQ-3 failure in the communication domain, and cord blood C-peptide might mediate this association. The findings, if confirmed by replications, specific nursing cares among pregnant women with poor CVH, might have implications for the offspring neurodevelopment prevention strategies targeting.

Koncept i značaj idealnog kardiovaskularnog zdravlja

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

Abstract 15375: Status of Cardiovascular Health and Early Carotid Artery Changes in Contemporary Young Adults From Disadvantaged Social Backgrounds: The Future of Families and Child Wellbeing Study (FFCWS)

Background: Effects of childhood social determinants of health (SDOH) on young adult cardiovascular health (CVH) are postulated, but few studies have measured both SDOH from birth and CVH status in young adulthood. Methods: In 1998-2000, FFCWS enrolled 4898 mother-baby dyads at delivery in 20 US cities, oversampling mothers who were unmarried, including a disproportionate number of minority and low-income families. In 2021-23, offspring were invited to an in-person exam for CVH measurement and carotid artery ultrasound. Individual CVH metrics (except sleep) and overall Life’s Essential 8 (LE8) scores (range, 0-100; higher = better CVH), as well as carotid intima-media thickness (IMT), were compared between self-identified sex and race/ethnicity groups. LE8 scores were also compared with a representative sample of US young adults aged 19-25 years from NHANES. Results: Among 1211 offspring participants (ppts), mean age was 22y, 55% were female, 50.8% Black, 25.1% Hispanic, 20.5% White, and 3.6% Other; characteristics at birth and through childhood were similar between FFCWS ppts who were/were not examined. Diet, physical activity, nicotine exposure, and BMI scores were unfavorable in FFCWS ppts (Table). Overall LE8 scores did not differ significantly by sex, and ranged from 64.6 in Black ppts to 74.8 in ppts from Other racial/ethnic groups. LE8 scores did not differ between Black and Hispanic ppts, but both groups had significantly lower scores than ppts from White and Other groups (all P≤0.01). After adjustment for age, sex, and LE8 score, Black ppts had significantly greater mean-maximum and mean-mean carotid IMT. Mean LE8 scores were lower among FFCWS ppts compared with young adults from the same racial/ethnic groups in NHANES. Conclusions: In this novel cohort of young adults largely from disadvantaged social backgrounds, overall CVH status was sub-optimal, and ppts who identified as Black had the lowest CVH and highest carotid IMT measures, even at this young age.

Patient reported outcome measures and cardiovascular outcomes following high dose modern intravenous iron in non-dialysis dependent chronic kidney disease: secondary analysis of ExplorIRON-CKD

Intravenous iron is commonly used to treat iron deficiency anemia in non-dialysis chronic kidney disease (ND-CKD). There is a paucity of information on the potential impact of intravenous iron on patient reported outcome measures, functional status and markers of cardiovascular health. As part of the secondary analysis of this double-blind exploratory randomized controlled trial focusing on patients with iron deficiency (+ /− anemia) and ND-CKD (serum ferritin < 200 µg/L or transferrin saturation ≤ 20% and serum ferritin 200–299 µg/L; CKD stages: 3a-5), 26 patients were randomized in a 1:1 ratio to receive ferric derisomaltose or ferric carboxymaltose. Participants received 1000 mg at baseline and 500–1000 mg at one month to achieve iron repletion. Quality of life and fatigue status were assessed using the Short-Form (36) questionnaire and the fatigue severity scale. Functional status was evaluated using the Duke Activity Status Index and the 1-min-sit-to-stand test. Cardiac markers such as NT-proBNP, Troponin T and pulse wave velocity were monitored. Intravenous iron was associated with similar improvements in most domains of the Short-Form (36) questionnaire, fatigue status, and 1-min-sit-to-stand ability increased significantly by the end of the trial in both groups (p < 0.001). Markers of cardiac function remained stable, with no arterial stiffness impact. Longer term studies are required to further evaluate the impact of intravenous iron on quality of life and cardiac safety in patients with ND-CKD.

Status of Maternal Cardiovascular Health in American Indian and Alaska Native Individuals: A Scientific Statement From the American Heart Association.

Cardiovascular disease is the leading cause of pregnancy-related death in the United States. American Indian and Alaska Native individuals have some of the highest maternal death and morbidity rates. Data on the causes of cardiovascular disease-related death in American Indian and Alaska Native individuals are limited, and there are several challenges and opportunities to improve maternal cardiovascular health in this population. This scientific statement provides an overview of the current status of cardiovascular health among American Indian and Alaska Native birthing individuals and causes of maternal death and morbidity and describes a stepwise multidisciplinary framework for addressing cardiovascular disease and cerebrovascular disease during the preconception, pregnancy, and postpartum time frame. This scientific statement highlights the American Heart Association's factors for cardiovascular health assessment known collectively as Life's Essential 8 as they pertain to American Indian and Alaska Native birthing individuals. It summarizes the impact of substance use, adverse mental health conditions, and lifestyle and cardiovascular disease risk factors, as well as the cascading effects of institutional and structural racism and the historical trauma faced by American Indian and Alaska Native individuals. It recognizes the possible impact of systematic acts of colonization and dominance on their social determinants of health, ultimately translating into worse health care outcomes. It focuses on the underreporting of American Indian and Alaska Native disaggregated data in pregnancy and postpartum outcomes and the importance of engaging key stakeholders, designing culturally appropriate care, building trust among communities and health care professionals, and expanding the American Indian and Alaska Native workforce in biomedical research and health care settings to optimize the cardiovascular health of American Indian and Alaska Native birthing individuals.

Abstract MP16: Status of Cardiovascular Health in US Immigrants Using the AHA’s Life’s Essential 8 Metrics: Prevalence Estimates and Social Determinants From the 2013-2018 National Health and Nutrition Examination Survey

Introduction: The US has the largest immigrant population globally, with a record high ~47 million foreign-born residents in 2022. Immigrants endure social and structural factors that may adversely influence their cardiovascular health (CVH). Hypothesis: Overall and individual metrics of CVH will vary by immigration status (US-born vs. foreign-born) and among foreign-born sub-populations. Methods: The analytic sample included 13,471 adults (19% foreign-born), ages 20-79 y (not pregnant or institutionalized) and free of CVD, from the 2013-2018 NHANES. We calculated the CVH score (range 0-100, low CVH: &lt;50) and component scores, consistent with AHA’s Life’s Essential 8 guidelines. T-tests were used to compare CVH scores by nativity and, among foreign-born individuals, by sex, ethnicity, years in the US, and citizenship. Survey weighted logistic models evaluated social determinants of health (SDOH) in relation to odds of having low CVH. Results: Compared to US-born adults, foreign-born adults had higher overall CVH, diet, nicotine exposure, BMI, and blood pressure scores, but lower physical activity, glucose, and cholesterol scores (p&lt;0.01); there were no differences in sleep health scores (Figure A). Among immigrants, those who were men, Hispanic, and living in the US ≥15y had lower CVH scores (p&lt;0.001); CVH scores did not differ by citizenship (Figure B-E). Scores for individual CVH metrics also varied across immigrant sub-populations. In logistic models, being male, 45+ y, Hispanic, food insecure, or having &lt; college education, depression, or ≥15y in the US was related to 57%-150% higher odds of having low CVH. Marital status, income, health insurance, citizenship, and home ownership were not related to CVH. Conclusions: While US immigrants have higher overall CVH compared to US-born persons, CVH status is complex and varies across immigrant sub-populations. Understanding immigration as a SDOH is essential for effective public health initiatives aimed at improving CVH in the heterogeneous US immigrant population.

Abstract P132: Application of Life’s Essential 8 to Assess the Status of Cardiovascular Health Among 4-to-6-year-old Children in the Healthy Start Study

Introduction: The American Heart Association recently put forth the Life’s Essential 8 (LE8) scoring system to assess cardiovascular health (CVH) status based on four health factors: body mass index [BMI], fasting glucose, non-high-density-lipoprotein cholesterol, and blood pressure; and four behavioral factors: first- and second-hand nicotine exposure, diet quality, physical activity, and sleep duration. Few studies have applied LE8 to assess CVH in children, and little remains known about concordance in CVH status based on LE8 vs. Life’s Simple 7 (LS7), the prior scoring system that employed different definitions and thresholds for defining CVH. Objectives: (1) Apply LE8 to assess prevalence (%) of low, moderate, high, and optimal CVH in diverse 4-to-6-year old children; (2) Compare concordance in CVH status categories based on LE8 vs. LS7. Hypothesis: Use of LE8 will yield at least 20% prevalence of high and optimal CVH; this prevalence will be higher than estimates based on LS7. Methods: Using data from 305 children in the Healthy Start cohort, we applied the LE8 scoring system to derive a composite CVH score for each child and estimated % low (LE8 CVH score &lt;50 of 100 possible points), moderate (score 50-&lt;80), high (score 80-&lt;100), and optimal CVH (score=100). Next, we applied the LS7 scoring system to estimate % of participants in the same four categories (low CVH: LS7 CVH score &lt;7 of 14 possible points; moderate CVH: score 7-&lt;10.5; high CVH: score 10.5-&lt;14; optimal CVH: score=14). Finally, we assessed concordance in prevalence across CVH status categories for LE8 vs. LS7 using the Wald chi-squared test, and calculated the correlation between continuous CVH scores based on LE8 and LS7. Results: The average age of participants was 4.7±0.6 y. Forty-five percent were female (n=136); 62% identified as white, 23% as Hispanic, and 12% as Black. No children had low or optimal CVH with either scoring system. However, prevalence of high CVH was higher based on LE8 than LS7 (40.6% vs. 33.4%; P &lt;0.0001). Twenty-one percent of participants had high CVH according to both scoring systems. We observed a moderate positive correlation (Pearson R 2 =0.55) between continuous CVH scores for LE8 and LS7. Conclusions: While no participants had low or optimal CVH in Healthy Start during early childhood, LE8 yielded a higher prevalence of high CVH than LS7. Future studies are warranted to assess determinants and consequences of CVH status during this life stage.

Correction to: 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.

Correction to: 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.

Cardiovascular health status in Chinese Cardiologists: China Cardiologist Heart Survey II

Background and purpose: Cardiologists represent a subset of the population with the highest degree of awareness to cardiovascular diseases (CVD), and thus should have low exposure to modifiable risks and low CVD prevalence. However, the status of cardiovascular health in Chinese cardiologists remains unknown. Methods: China Cardiologist Heart Survey II is a nation-wide cross-sectional survey on licensed cardiologists in Chinese mainland. It was conducted between August 2020 and November 2021. An online questionnaire was used to acquire demographic and lifestyle information, cardiovascular risk factors, CVD status, and medications. Crude prevalence of cardiovascular risk factors, organ damage, and CVD were calculated and compared between sexes and between sub-specialties. Age-weighted prevalence of cardiovascular risk factors were compared to that in the general Chinese population in the literature. Results: The final analysis included a total of 15,827 cardiologists at the age of 25 to 60 years from 31 provinces. The median age was 38 years and 8650 (54.7%) were men. The most common cardiovascular risk factor was family history of premature CVD (20.4%), followed by hypertension (12.4%), hyperlipidemia (10.6%), overweight/obesity (8.3%), smoking (7.3%), and diabetes (2.4%). The most common sub-clinical organ damages included carotid plaque (3.4%) and microalbuminuria (1.2%). The rate of confirmed coronary artery disease was 0.4%. The rate of arrhythmia was 3.1%. The rate of obstructive sleep apnea syndrome was 2.2%. The rate of cardiovascular risk factors and organ damage was higher in men versus in women, and higher in interventional versus non-interventional cardiologists. In comparison to the data reported for the general population in China, cardiologists had lower age-weighted prevalence of hypertension (15.2% vs. 23.2%), diabetes (3.1% vs. 10.9%), hyperlipidemia (12.3% vs. 40.4%), obesity (2.1% vs. 11.9%), and smoking (7.7% vs. 27.7%). Conclusions: In comparison to the general public, cardiologists in Chinese mainland had much lower age-weighted prevalence of cardiovascular risk factors, but there is substantial room for further improvement, particularly in male and interventional cardiologists.

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.

Status of Cardiovascular Health in Chinese Children and Adolescents

The American Heart Association defined "ideal cardiovascular health (CVH)" in pediatric populations to promote primordial prevention in cardiovascular diseases. Little is known about CVH and associated sociodemographic factors among Chinese children and adolescents. This study aimed to evaluate CVH and the associations with sociodemographic characteristics in Chinese children and adolescents. This cross-sectional study analyzed baseline data of 15,583 participants aged 7 to 17 years from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated according to 4 health behaviors (nonsmoking, body mass index, physical activity, and diet) and 3 health factors (total cholesterol, blood pressure, and fasting plasma glucose), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and the number of ideal CVH metrics. The prevalence of ideal CVH status was 1.7% (males: 1.9%; females: 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors was 3.1% (males 3.3%; females: 3.0%) and 53.6% (males: 52.4%; females: 54.9%), respectively. Ideal fasting plasma glucose was the most prevalent component (males: 94.4%; females: 97.4%), whereas ideal physical activity (males: 34.6%; females: 23.9%) and diet (males: 28.3%; females: 30.1%) were the least prevalent. Female sex, younger age, undeveloped economy, residence in the southern region, and no family history of cardiovascular diseases were associated with more ideal CVH metrics. Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet arekeytopromotion of CVH. Effective interventions are needed to promote CVH and reduce health disparities in early life.

The Timing and Sequence of Cardiovascular Health Decline

Childhood declines in cardiovascular health have been linked to the development of subclinical atherosclerosis; however, less is known about the timing and sequence of the decline of the specific cardiovascular health components. The study objective is to identify the patterns of decline and associations with adulthood subclinical atherosclerosis. Data were pooled from 5 cardiovascular cohorts. Clinical components of cardiovascular health (BMI, blood pressure, cholesterol, and blood glucose) were categorized as ideal or nonideal using American Heart Association definitions. Multitrajectory models simultaneously fitted the probability ideal for each factor. Adjusted associations between trajectory groups and carotid intima-media thickness were modeled. Data were pooled from December 1, 2015 to June 1, 2019; statistical analysis occurred between June 1, 2019 and June 1, 2020. This study included 9,388 individuals (55% female, 66% White). A total of 5 distinct trajectory groups were created: 1 maintained the ideal levels of all the 4 health factors, 2 had risk onset of a single factor in childhood, 1 had risk onset of multiple factors in childhood, and 1 had risk onset in adulthood. Those with childhood multiple risk onset had 8.1% higher carotid intima-media thickness (95% CI=0.067, 0.095) than those in the ideal group, childhood cholesterol risk onset had 5.9% higher carotid intima-media thickness (95% CI=0.045, 0.072), childhood BMI risk onset had 5.5% higher carotid intima-media thickness (95% CI=0.041, 0.069), and early adulthood multiple risk onset had 2.7% higher carotid intima-media thickness (95% CI=0.013, 0.041). Those who lost the ideal status of cardiovascular health in childhood and early adulthood had more subclinical atherosclerosis than those who retained the ideal cardiovascular health across the life course, underscoring the importance of preserving the ideal cardiovascular health beginning in childhood and continued into adulthood.

Status of Cardiovascular Health in Chinese Children and Adolescents: A Cross-Sectional Study in China

Background: This study aimed to evaluate cardiovascular health (CVH) status and the associations with sociodemographic characteristics among Chinese children and adolescents. Methods: This cross-sectional study analyzed baseline data of 15583 participants aged 7-17y from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated by four health behaviors (non-smoking, body mass index, physical activity, diet) and three health factors (total cholesterol, blood pressure, and fasting plasma glucose (FPG)), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and CVH. Findings: The prevalence of ideal CVH status was 1.7% (boys 1.9%, girls 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors were 3.1% (boys 3.3%, girls 3.0%) and 53.6% (boys 52.4%, girls 54.9%). Ideal FPG was the most prevalent component (boys 94.4%, girls 97.4%), whereas ideal physical activity (boys 34.6%, girls 23.9%) and diet (boys, 28.3%; girls, 30.1%) were the least prevalent. Girls, younger age, undeveloped economy, southern region, no family history were associated with more ideal CVH metrics. Interpretation: Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet are key to CVH promotion. Effective interventions are needed to improve health disparities in terms of socio-demographic characteristics. Funding Information: This project has been funded by the Special Research Grant for Non-profit Public Service of the Ministry of Health of China (No.201202010), the Guangdong Provincial Natural Science Foundation (No.2017A030313844 and No.2021A1515010439), and the Research fund for medical science. Declaration of Interests: No conflicts of interest exist. Ethics Approval Statement: The Ethical Committee of Peking University approved the study’s protocol. All students and parents participated in this study with written informed consent voluntarily.

Short-Term Consequences of Pediatric Anti-cancer Treatment Regarding Blood Pressure, Motor Performance, Physical Activity and Reintegration Into Sports Structures.

Background: Cardiovascular diseases in childhood cancer survivors are known late sequelae following treatment. Arterial stiffness, pulse wave velocity (PWV) and central systolic blood pressure (cSBP) are potential predictors to assess the status of cardiovascular health. Frequent inpatient stays and reduced physical activity (PA) during treatment can lead to noticeable impairments regarding motor skills and physical performance. The present study examined parameters of cardiovascular health, motor performance and the status of integration into sports structures shortly after cessation of treatment.Methods: A cross-sectional, monocentric study was conducted from April to June 2019. Participants (6–18 yrs, mixed cancer entities) during maintenance therapy and follow-up care were recruited. Peripheral and central systolic/diastolic blood pressure (pSBP, pDBP, cSBP) and PWV were assessed using the Mobil-O-Graph®. The MOON test (MOtor performance in pediatric ONcology) was used to scale motor performance. PA levels and status of integration into sports structures were assessed with a questionnaire referring to the KiGGS study. All measured data were compared to published reference values.Results: Forty participants (11.3 ± 3.8 years, 50% female) were recruited 1.6 ± 1.8 years post-treatment. PSBP (z-score: 0.87 ± 0.67, p = 0.003), pDBP (0.83 ± 1.94, p = 0.033) and cSBP (≥8 years: 0.60 ± 1.29, p = 0.011) were significantly increased compared to reference values. PWV was also elevated, but not significantly. Motor performance was reduced in almost all motor abilities. Thirty-six percent of the examined group did not participate in physical education at school to the full extent. Only 17% reported 1 hour of daily moderate-to-vigorous PA as recommended for children and adolescents by the World Health Organization. Half of the participants were active sports club members before treatment, but one third did not resume their former membership.Conclusion: Increased cardiovascular parameters and impaired motor performance shortly after cessation of treatment, physical inactivity, and low rates of integration into regular sports programs highlight the support needed. Young cancer patients should receive early support in coping with physical limitations preferably soon after diagnosis. Motor deficits could be reduced by applying targeted interventions. Furthermore, a regular sports therapy program during in- and outpatient care could increase engagement in PA to possibly counteract risk factors and improve cardiovascular health.

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.

Consumption of a multivitamin/multimineral supplement for 4 weeks improves nutritional status and markers of cardiovascular health

Abstract Background The efficacy of multivitamin/multimineral (MVM) supplementation continues to provoke considerable debate. The purpose of this study was to determine if MVM supplementation affects indices of nutrition status, antioxidant status and cardiovascular health in healthy individuals. Methods 23 subjects (10 female, 13 male) were enrolled in a 4-week, double-blind, placebo-controlled study. Fasting blood samples were collected and analyzed at baseline and at study completion (i.e., final). Results Comparison of baseline and final values indicated that placebo treatment had no significant effect, whereas MVM treatment significantly (p Conclusion MVM supplementation improved several indices of human health that may bestow particular health benefits among MVM users.

Status of cardiovascular health in the Republic of Serbia: Results from the National Health Survey.

BackgroundCardiovascular diseases (CVD) remain the most significant cause of death in low- and middle-income countries where the burden of CVD continues to rise due to the increasing incidence of CVD. The aim of this study was to assess the prevalence of ideal cardiovascular health (CVH) across sex and age groups and to analyze associations between demographic and socio-economic variables and ideal CVH metrics in the adult population of the Republic of Serbia.MethodsInformation on demographic (age, sex, marital status, and type of settlement) and socio-economic characteristics (education, and wealth index), and the 7 ideal CVH metrics (smoking, physical activity, healthy diet, BMI, blood pressure, cholesterol, and glucose) was obtained for 13100 respondents aged 20 years and above, from the 2013 National Health Survey in the Republic of Serbia. According to the American Heart Association, the ideal CVH was defined as the simultaneous presence of 7 ideal CVH metrics.ResultsOut of all ideal CVH metrics, the most prevalent components were ideal glucose (92.2%), ideal cholesterol (86.4%) and ideal smoking (63%), while the least prevalent ideal CVH component was ideal healthy diet (2.4%). Only 0.1% had all 7 CVH components at the ideal level. According to the multivariable logistic regression analysis the higher number of ideal CVH metrics was observed in women (OR = 4.46), younger people (OR = 7.12), people living without partner (OR = 1.70), more educated (OR = 2.51 for middle educated and OR = 3.57 for high educated), as well as among the rich (OR = 1.43).ConclusionOur findings of existing age-specific, sex and socio-economic differences in the prevalence and number of ideal CVH metrics should serve for the development of appropriate CVD prevention policies tailored to fit specific needs of both sexes, all age groups and people with different socioeconomic status.

Parameters of Bone and Cardiovascular Health Related to 25-Hydroxyvitamin D Status in Emirati Nationals attending Primary Care and Diabetes services: a retrospective cohort study

Vitamin D deficiency is endemic in people living in the Gulf states. We performed a retrospective analysis of data gathered at the first attendance of 82,396 Emirati nationals to outpatient diabetes, endocrinology and general primary care services at two centres in the United Arab Emirates during 2012–2016. Our aim was to explore associations between vitamin D status and markers of cardiovascular and bone health. In the study population, 67.1% of men and 73.5% of women had serum 25(OH)D of less than 50 nmol/L, with the lowest levels being found in young adults. Among Emirati adults with type 2 diabetes, serum 25(OH)D < 50 nmol/L was associated with an increased risk of a coexisting adverse total cholesterol:HDL (TC:HDL) ratio (odds ratio 2.13 (1.60–2.84), p < 0.001). Correcting for age, sex, body mass index, HbA1c and statin therapy, an increase in 25(OH)D of 1 nmol/L was associated with a 0.01 unit reduction in TC:HDL in this population. In a subset of 1064 adult individuals, 25(OH)D < 25 nmol/L was associated with a reduction in DEXA-measured z-score of −0.29 (−0.44 to −0.15, p < 0.001) at the femoral neck and of −0.25(−0.45 to −0.05, p = 0.015) at L1–4, corrected for body mass index, compared with individuals with 25(OH)D ≥ 75 nmol/L. Our findings raise concerns regarding lifetime burden of cardiovascular disease and bone health for young Emiratis with vitamin D deficiency.