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Tang Y, Chen X, Zhao Y, Sun J, Jiang Y. Gender differences in the association between Life's essential 8 and cardiovascular disease: a U.S.-based cross-sectional analysis. Nutr Metab (Lond) 2025; 22:38. [PMID: 40336000 PMCID: PMC12060376 DOI: 10.1186/s12986-025-00929-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 04/22/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND This research aims to elucidate the gender differences in the association between cardiovascular disease (CVD) prevalence and Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH). METHODS This study included participants from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018.The scores of LE8, health behavior, health factor and each metric based on diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipid, blood glucose, and blood pressure were classified as low (0-49 points), moderate (50-79 points), and high (80-100 points). The scores of LE8, health behavior and health factor as continuous variables were also used for dose-response analysis. The main outcomes included the prevalence of CVD. The definition of CVD based on self-reported history of coronary heart disease or stroke. RESULTS A total of 23,307 individuals were included in this analysis. Participants with CVD had significantly lower LE8 scores compared to those without CVD, and females demonstrated higher CVH levels compared to males including total LE8 scores and the scores of diet, nicotine exposure, blood lipid, blood glucose, and blood pressure (P < 0.05). Moreover, the LE8 score demonstrated a non-linear association with CVD in both males and females (all P-values for non-linearity were < 0.001). Furthermore, compared to the low LE8 level, a high LE8 level was associated with a 78% decreased risk of CVD in males (HR: 0.22, 95% CI: 0.16-0.31) and an 83% decreased risk in females (HR: 0.17, 95% CI: 0.11-0.26). Consistently, compared to low levels of health behaviors and health factors, higher levels were significantly associated with a decreased risk of CVD in both males and females (All P < 0.001). Additionally, the area under the curve (AUC) for the total LE8 score in CVD discrimination was significantly higher in females than in males (P < 0.001). CONCLUSION Higher CVH scores were associated with a lower risk of CVD, especially in females. These findings highlight the need for gender-specific preventive strategies in CVH promotion, with a particular focus on improving LE8 scores in high-risk populations.
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Affiliation(s)
- Yi Tang
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Xiaojie Chen
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yifan Zhao
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jihong Sun
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yaohui Jiang
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Sattler EL, Lassale C, Diaw M, Joseph JJ, Singh G, Samb A, Lloyd-Jones DM, Gaye B. Changes in Cardiovascular Health at Midlife and Subsequent Cardiovascular Outcomes in Individuals With Diabetes. JACC. ADVANCES 2025; 4:101450. [PMID: 39801817 PMCID: PMC11719311 DOI: 10.1016/j.jacadv.2024.101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 10/17/2024] [Accepted: 11/04/2024] [Indexed: 01/16/2025]
Abstract
Background Whether improvements in cardiovascular health (CVH) in midlife mitigate cardiovascular disease (CVD) risk in patients with diabetes remains underexplored. Objectives The aim of the study was to examine the relationships between changes in CVH during midlife and subsequent risks of CVD events and all-cause mortality among individuals with and without diabetes. Methods The study utilized data from the Atherosclerosis Risk in Communities Study. CVH data were collected during visits 1 and 3 and the median follow-up was 23 years. CVH was based on ideal Life's Simple 7 metrics and categorized as low (0-2 metrics), moderate (3 or 4 metrics), and favorable CVH (5-7 metrics). Cox proportional hazards regression models were used to determine the association between changes in CVH and CVD outcomes. Results Among the final sample (N = 8,741), 806 had diabetes (9.2%). Of those with diabetes, 62.3% had low CVH at both visits, 12.0% maintained moderate CVH, 15.0% showed improvement, and 10.3% experienced a decline in CVH. Only 0.4% maintained favorable CVH. Those with improved CVH had lower CVD event risks (HR: 0.69; 95% CI: 0.50-0.93), as did those who maintained moderate CVH (HR: 0.68; 95% CI: 0.50-0.94) or shifted from moderate to low CVH (HR: 0.60; 95% CI: 0.41-0.88). Similar patterns were observed for all-cause mortality. In comparison to participants without diabetes who maintained a favorable CVH trajectory at midlife, those with diabetes consistently displayed higher risks of CVD events and mortality, regardless of their CVH trajectory. Conclusions For patients with diabetes, achieving or maintaining ideal CVH levels at midlife may help improve outcome; however, CVD risk is not completely mitigated by favorable CVH trajectories.
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Affiliation(s)
- Elisabeth L.P. Sattler
- Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, Georgia, USA
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, Georgia, USA
- Alliance for Medical Research in Africa (AMedRA), Dakar, Senegal
| | - Camille Lassale
- Alliance for Medical Research in Africa (AMedRA), Dakar, Senegal
- Cardiovascular Risk and Nutrition Group, Hospital del Mar Research Institute, Barcelona, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Mor Diaw
- Alliance for Medical Research in Africa (AMedRA), Dakar, Senegal
- Department of Physiology, Cheikh Anta Diop University, Dakar, Senegal
| | - Joshua J. Joseph
- Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Gurbinder Singh
- Alliance for Medical Research in Africa (AMedRA), Dakar, Senegal
| | - Abdoulaye Samb
- Alliance for Medical Research in Africa (AMedRA), Dakar, Senegal
- Department of Physiology, Cheikh Anta Diop University, Dakar, Senegal
| | - Donald M. Lloyd-Jones
- Department of Preventive Medicine, Department of Medicine, Division of Cardiology, Northwestern University Feinberg, School of Medicine, Chicago, Illinois, USA
| | - Bamba Gaye
- Alliance for Medical Research in Africa (AMedRA), Dakar, Senegal
- Department of Physiology, Cheikh Anta Diop University, Dakar, Senegal
- Department of Biomedical Informatics, Emory University, Atlanta, Georgia, USA
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Song C, Cheng X, Bai Y. Association of change in cardiovascular health based on life's essential 8 with incident cardiovascular disease. Am J Prev Cardiol 2024; 18:100668. [PMID: 38646020 PMCID: PMC11033071 DOI: 10.1016/j.ajpc.2024.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/13/2024] [Accepted: 04/04/2024] [Indexed: 04/23/2024] Open
Abstract
Objective To evaluate whether and to what extent changes in cardiovascular health (CVH) based on life's essential 8 (LE8) are associated with incident cardiovascular disease (CVD). Methods A total of 7,194 participants were derived from UK Biobank. CVH was evaluated using a modified version of LE8. Participants were classified into three groups according to their LE8 score: high CVH (LE8 score≥80), moderate CVH (50≤LE8 score<80), and low CVH (LE8 score<50). Changes in CVH between 2006/2010 and 2012/2013 were analyzed. Results During a median of 10.3 years of follow-up, CVD was observed in 597 participants. Compared to the consistent moderate group, the moderate to low group was associated with about 128 % increased risk of CVD (Hazard ratio [HR]: 2.28; 95 % confidence interval [CI]: 1.61, 3.23), and the relevant HR (95 % CI) was 2.19 (1.46, 3.29) for the consistent low group; no statistically significant results were observed in the other groups. Moreover, no statistically significant exposure-response association between absolute change in LE8 score and incident CVD was documented (Poverall=0.15). Conclusion Change in CVH based on LE8 was associated with the risk of CVD; however, the relationship varied widely in different CVH change patterns.
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Affiliation(s)
- Chao Song
- Nosocomial Infection Control Center, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
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Rempakos A, Prescott B, Mitchell GF, Vasan RS, Xanthakis V. Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study. J Am Heart Assoc 2023; 12:e030764. [PMID: 38014669 PMCID: PMC10727315 DOI: 10.1161/jaha.123.030764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The association of the American Heart Association's updated cardiovascular health score, the Life's Essential 8 (LE8), with cardiovascular disease (CVD) and death is not described in the FHS (Framingham Heart Study). METHODS AND RESULTS We evaluated Framingham Offspring participants at examinations 2 and 6 (n=2888 and 1667; and mean age, 44 and 57 years, respectively), free of CVD with information on LE8 components. Using age-sex-adjusted Cox models, we related LE8 and its change (examination 2 to examination 6) with CVD and death risk and compared associations with those of the Life's Simple 7 score. Mean LE8 score at examination 2 was 67 points (minimum, 26 points; maximum, 100 points). At both examinations, participants were reclassified to a different cardiovascular health status, depending on which method (LE8 versus Life's Simple 7) was used (60% of participants in ideal Life's Simple 7 status were in intermediate LE8 category). On follow-up after examination 2 (median, 30 and 33 years for CVD and death, respectively), we observed 966 CVD events, and 1195 participants died. Participants having LE8≥68 (sample median) were at lower CVD and death risk compared with those with LE8<68 (examination 2: CVD hazard ratio [HR], 0.47 [95% CI, 0.41-0.54]; death HR, 0.55 [95% CI, 0.49-0.62]; all P<0.001). Participants maintaining low LE8 scores during life course were at highest CVD and death risk (CVD: HRs ranging from 1.8 to 2.3; P<0.001; death HR, 1.45 [95% CI, 1.13-1.85]; P=0.003 versus high-high group). CONCLUSIONS Further studies are warranted to elucidate whether the LE8 score is a better marker of CVD and death risk, compared with Life's Simple 7 score.
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Affiliation(s)
| | - Brenton Prescott
- Section of Preventive Medicine and Epidemiology, Department of MedicineBoston University School of MedicineBostonMA
| | | | - Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Department of MedicineBoston University School of MedicineBostonMA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
- Department of EpidemiologyBoston University School of Public HealthBostonMA
- University of Texas School of Public HealthSan AntonioTX
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Department of MedicineBoston University School of MedicineBostonMA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
- Department of BiostatisticsBoston University School of Public HealthBostonMA
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Tian Q, Chen S, Meng X, Wang H, Li C, Zheng D, Wu L, Wang A, Wu S, Wang Y. Time spent in a better cardiovascular health and risk of cardiovascular diseases and mortality: a prospective cohort study. J Transl Med 2023; 21:469. [PMID: 37452344 PMCID: PMC10349449 DOI: 10.1186/s12967-023-04252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The protective effect of a higher ideal cardiovascular health (CVH) score on cardiovascular diseases (CVDs) and mortality is well recognized. However, little is known regarding the length of favorable CVH status associated with CVDs and mortality. This study aimed to examined whether the duration of better (ideal or intermediate) CVH is associated with risk of developing CVDs and mortality. METHODS This prospective cohort study used data from 83,536 individuals from 2006 to 2020 who were enrolled in the Kailuan Study. The CVH scores of individuals were assessed at visits 1, 2, 3, and 4, respectively. The years spent in better CVH were estimated for each individual as the number of examination cycles (0-4) in which the participant was in that CVH score ≥ 8 multiplied by 2 (the mean year interval of each visit). The primary outcomes are CVD events and all-cause mortality. RESULTS After a median follow-up period of 7.48 years, 5486 (7.07%) cases of incident CVD events and 7669 (9.18%) deaths occurred. Compared with participants in " ≤ 4 years" group, those who maintained for > 4 years had less likely to develop adverse outcomes (CVD events: hazard ratio (HR): 0.60, 95% confidence interval (CI 0.56-0.63; all-cause mortality: HR: 0.77, 95% CI 0.74-0.81). The number of years spent in better CVH was nonlinearly correlated with CVD events or mortality (all Ps for nonlinear < 0.05). The results indicated that maintaining more than 6 years in a better CVH status was associated with a decreased risk of CVD events or mortality. CONCLUSION Our study indicates that individuals maintaining more than 6 years in better CVH could increase cardiometabolic benefits and a lower risk of all-cause mortality.
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Affiliation(s)
- Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua East Road, Tangshan, 063000, China
| | - Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Haotian Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Cancan Li
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Deqiang Zheng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Aitian Wang
- Department of Intensive Medicine, Kailuan General Hospital, Tangshan, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua East Road, Tangshan, 063000, China.
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China.
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Herraiz-Adillo Á, Ahlqvist VH, Higueras-Fresnillo S, Berglind D, Wennberg P, Lenander C, Daka B, Ekstedt M, Sundström J, Ortega FB, Östgren CJ, Rådholm K, Henriksson P. Life's Essential 8 and carotid artery plaques: the Swedish cardiopulmonary bioimage study. Front Cardiovasc Med 2023; 10:1173550. [PMID: 37424911 PMCID: PMC10323823 DOI: 10.3389/fcvm.2023.1173550] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Background To quantify cardiovascular health (CVH), the American Heart Association (AHA) recently launched an updated construct of the "Life's Simple 7" (LS7) score, the "Life's Essential 8" (LE8) score. This study aims to analyse the association between both CVH scores and carotid artery plaques and to compare the predictive capacity of such scores for carotid plaques. Methods Randomly recruited participants aged 50-64 years from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analysed. According to the AHA definitions, two CVH scores were calculated: i) the LE8 score (0, worst CVH; 100, best CVH) and two different versions of the LS7 score [(0-7) and (0-14), 0 indicating the worst CVH]. Ultrasound-diagnosed carotid plaques were classified as no plaque, unilateral, and bilateral plaques. Associations were studied by adjusted multinomial logistic regression models and adjusted (marginal) prevalences, while comparison between LE8 and LS7 scores was performed through receiver operating characteristic (ROC) curves. Results After exclusions, 28,870 participants remained for analysis (50.3% women). The odds for bilateral carotid plaques were almost five times higher in the lowest LE8 (<50 points) group [OR: 4.93, (95% CI: 4.19-5.79); adjusted prevalence 40.5%, (95% CI: 37.9-43.2)] compared to the highest LE8 (≥80 points) group [adjusted prevalence 17.2%, (95% CI: 16.2-18.1)]. Also, the odds for unilateral carotid plaques were more than two times higher in the lowest LE8 group [OR: 2.14, (95% CI: 1.82-2.51); adjusted prevalence 31.5%, (95% CI: 28.9-34.2)] compared to the highest LE8 group [adjusted prevalence 29.4%, (95% CI: 28.3-30.5)]. The areas under ROC curves were similar between LE8 and LS7 (0-14) scores: for bilateral carotid plaques, 0.622 (95% CI: 0.614-0.630) vs. 0.621 (95% CI: 0.613-0.628), P = 0.578, respectively; and for any carotid plaque, 0.602 (95% CI: 0.596-0.609) vs. 0.600 (95% CI: 0.593-0.607), P = 0.194, respectively. Conclusion The new LE8 score showed inverse and dose-response associations with carotid plaques, particularly bilateral plaques. The LE8 did not outperform the conventional LS7 score, which showed similar ability to predict carotid plaques, especially when scored as 0-14 points. We conclude that both the LE8 and LS7 may be useful in clinical practice for monitoring CVH status in the adult population.
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Affiliation(s)
- Ángel Herraiz-Adillo
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Viktor H. Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sara Higueras-Fresnillo
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Cecilia Lenander
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Lund, Sweden
| | - Bledar Daka
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Ekstedt
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Johan Sundström
- Clinical Epidemiology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Francisco B. Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health, University Research Institute (iMUDS), University of Granada; CIBERobn Physiopathology of Obesity and Nutrition, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Karin Rådholm
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Gupta RD, Tamanna RJ, Hashan MR, Akonde M, Haider SS, Chakraborty PA, Hossain MB. Prevalence and Associated Factors with Ideal Cardiovascular Health Metrics in Bangladesh: Analysis of the Nationally Representative STEPS 2018 Survey. EPIDEMIOLOGIA 2022; 3:533-543. [PMID: 36547257 PMCID: PMC9778360 DOI: 10.3390/epidemiologia3040040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
This study aims to find out the prevalence of the American Heart Association's (AHA)'s cardiovascular health metrics and associated socio-demographic factors. A secondary analysis of the World Health Organization (WHO) STEPwise approach to surveillance survey 2018 (STEPS 2018) data was conducted. Ideal Cardiovascular Health (ICH) was defined as the presence of 5-7 ideal metrics as defined by the AHA. Design-adjusted multivariable logistic regression was used to determine the associated factors of ICH. In total, 5930 respondents were included in our analysis, and 43.1% of the participants had ICH. The odds of ICH decreased with age [compared to 18-29 years old individuals, 30-49 years: AOR (Adjusted Odds Ratio): 0.4; 95% Confidence Interval (CI): 0.4-0.5; 50-69 years: AOR: 0.7; 95% CI: 0.6-0.8], and higher educational attainment (compared to those who received no formal education, being educated up to primary level: AOR:0.7; 95% CI: 0.6-0.8; being educated up to secondary level: AOR: 0.4; 95% CI: 0.4-0.5; being educated up to college and higher: AOR: 0.4; 95% CI: 0.3-0.5). Compared with female and urban residents, the odds were 30% and 40% less among male and rural residents, respectively. The public health promotion programs of Bangladesh should raise awareness among high-risk groups to prevent cardiovascular diseases.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Rownak Jahan Tamanna
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka 1000, Bangladesh
| | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka 1000, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton North, Queensland 4701, Australia
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z8, Canada
| | - Md. Belal Hossain
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z8, Canada
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Lassale C, Cene C, Asselin A, Sims M, Jouven X, Gaye B. Sociodemographic determinants of change in cardiovascular health in middle adulthood in a bi-racial cohort. Atherosclerosis 2022; 346:98-108. [DOI: 10.1016/j.atherosclerosis.2022.01.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/25/2021] [Accepted: 01/14/2022] [Indexed: 12/24/2022]
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Janković J, Mandić-Rajčević S, Davidović M, Janković S. Demographic and socioeconomic inequalities in ideal cardiovascular health: A systematic review and meta-analysis. PLoS One 2021; 16:e0255959. [PMID: 34379696 PMCID: PMC8357101 DOI: 10.1371/journal.pone.0255959] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/28/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH. METHODS A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I2 statistics. RESULTS This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics. CONCLUSIONS To the best of our knowledge, this is the first systematic review on the relationship between participants' socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.
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Affiliation(s)
- Janko Janković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Stefan Mandić-Rajčević
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Maša Davidović
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Slavenka Janković
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Hernández-Vásquez A, Chacón-Torrico H, Vargas-Fernández R, Bendezu-Quispe G, Santero M. Metrics of Ideal Cardiovascular Health are Unequally Distributed between Peruvian Men and Women: Analysis of a National Population-Based Survey in 2017. Int J Prev Med 2020; 11:190. [PMID: 33815714 PMCID: PMC8000168 DOI: 10.4103/ijpvm.ijpvm_326_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/21/2019] [Indexed: 11/08/2022] Open
Abstract
Background: To determine socioeconomic inequalities in cardiovascular health (CVH) metrics among Peruvian adults as well as differences according to sex. Methods: An observational, cross-sectional study was conducted in 26,175 individuals aged 18–65 years using the 2017 Peruvian Demographic and Health Survey. According to the American Heart Association, 5 CVH metrics which comprised three ideal health behaviors (diet, non smoking, ideal body mass index [BMI]), and two ideal health factors (ideal blood pressure and no history of diabetes) were evaluated. The concentration curves (CC) methodology was used to analyze whether CVH metrics vary between socioeconomic status and sex. The concentration index (CI) was used to quantify socioeconomic-related inequality in health variables. Results: Overall, the mean age was 36.5 years (SD = 11.9) and 51.2% were women. Only 2.4% had 5 ideal CVH metrics (women 3.7%, men 1.0%) with a CI very close to the equality line (0.0135). (0.0135; higher in women [0.0262], compared to men [0,0002]). A greater prevalence of ideal CHV metrics (3 or more) was found in women (P < 0.001). Ideal health factors were more prevalent (52.1%) than ideal health behaviors (13.8%). Regarding inequality measures, CCs for most CVH metrics had a higher concentration in the lowest wealth population, except for ideal diet, which was more frequent among higher levels of wealth. An ideal BMI was the CVH metric with the lowest CI (overall: −0.0817; men: −0.2699). Conclusions: Peruvian women presented a higher prevalence of ideal CVH metrics and fewer inequalities. Ideal CVH metrics tend to be concentrated in the wealthiest women. Low- and middle-income countries should consider socioeconomic inequalities in cardiovascular disease prevention programs.
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Affiliation(s)
- Akram Hernández-Vásquez
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru
| | | | | | - Guido Bendezu-Quispe
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Marilina Santero
- Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
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11
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Ahmed A, Pinto Pereira SM, Lennon L, Papacosta O, Whincup P, Wannamethee G. Cardiovascular Health and Stroke in Older British Men: Prospective Findings From the British Regional Heart Study. Stroke 2020; 51:3286-3294. [PMID: 32912099 DOI: 10.1161/strokeaha.120.030546] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Research exploring the utility of cardiovascular health (CVH) and its Life's Simple 7 (LS7) components (body mass index, blood pressure [BP], glucose, cholesterol, physical activity, smoking, and diet) for prevention of stroke in older adults is limited. In the British Regional Heart Study, we explored (1) prospective associations of LS7 metrics and composite CVH scores with, and their impact on, stroke in middle and older age; and (2) if change in CVH was associated with subsequent stroke. METHODS Men without cardiovascular disease were followed from baseline recruitment (1978-1980), and again from re-examination 20 years later, for stroke over a median period of 20 years and 16 years, respectively. LS7 were measured at each time point except baseline diet. Cox models estimated hazard ratios (95% CI) of stroke for (1) ideal and intermediate versus poor levels of LS7; (2) composite CVH scores; and (3) 4 CVH trajectory groups (low-low, low-high, high-low, high-high) derived by dichotomising CVH scores from each time point across the median value. Population attributable fractions measured impact of LS7. RESULTS At baseline (n=7274, mean age 50 years), healthier levels of BP, physical activity, and smoking were associated with reduced stroke risk. At 20-year follow-up (n=3798, mean age 69 years) only BP displayed an association. Hazard ratios for intermediate and ideal (versus poor) levels of BP 0.65 (0.52-0.81) and 0.40 (0.24-0.65) at baseline; and 0.84 (0.67-1.05) and 0.57 (0.36-0.90) at 20-year follow-up. With reference to low-low trajectory, the low-high trajectory was associated with 40% reduced risk, hazard ratio 0.60 (0.44-0.83). Associations of CVH scores weakened, and population attributable fractions of LS7 reduced, from middle to old age; population attributable fraction of nonideal BP from 53% to 39%. CONCLUSIONS Except for BP, CVH is weakly associated with stroke at older ages. Prevention strategies for older adults should prioritize BP control but also enhance focus beyond traditional risk factors.
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Affiliation(s)
- Ayesha Ahmed
- Department of Primary Care and Population Health (A.A., L.L., O.P., G.W.), University College London
| | | | - Lucy Lennon
- Department of Primary Care and Population Health (A.A., L.L., O.P., G.W.), University College London
| | - Olia Papacosta
- Department of Primary Care and Population Health (A.A., L.L., O.P., G.W.), University College London
| | - Peter Whincup
- Population Health Research Institute, St George's, University of London (P.W.)
| | - Goya Wannamethee
- Department of Primary Care and Population Health (A.A., L.L., O.P., G.W.), University College London
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12
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Dong Y, Hao G, Wang Z, Wang X, Chen Z, Zhang L. Ideal Cardiovascular Health Status and Risk of Cardiovascular Disease or All-Cause Mortality in Chinese Middle-Aged Population. Angiology 2018; 70:523-529. [PMID: 30458624 DOI: 10.1177/0003319718813448] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ying Dong
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Guang Hao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, People’s Republic of China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
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13
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Hou J, Li J, Huang J, Lu C, Zhou J, Liu Y, Wu S, Wei F, Wang L, Chen H, Yu H, Wang Z, Jiang A. Relationship between the exposure to cumulative cardiovascular health behaviors and factors and chronic kidney disease-The Kailuan study. PLoS One 2018; 13:e0203171. [PMID: 30169509 PMCID: PMC6118362 DOI: 10.1371/journal.pone.0203171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022] Open
Abstract
It is unclear whether ideal cardiovascular health (CVH) behaviors and factors, particularly cumulative exposure to ideal CVH (cumCVH), is associated with chronic kidney disease (CKD). The aim of the study was to examine the effect of cumCVH on CKD using the data from the Kailuan study. The study included the 27,970 (21,199 males) of the Kailuan community (China). The participants were 19 to 98 years of age. They were followed in 2008-2009, 2010-2011, and 2012-2013 by the same medical staff that did the initial physical examinations in 2006-2007. Participants were censored on the visit reporting CKD. A CVH score was created based on the seven AHA health metrics. The cumCVH score was CVH1×timev1-v2+CVH2×timev2-v3+CVH3×timev3-v4. In the fully adjusted model, compared with the lowest quintile of cumCVH, individuals in the highest quintile had a 75% lower risk of CKD (95% confidence interval (CI): 66-82%). Every additional year lived with a 1-unit increase in ideal CVH was associated with an 11% (95% CI: 9-13%) reduction in the incidence of CKD. Furthermore, when we excluded each of the six metrics from the cumCVH score in turn, the association was unaffected after the exclusion of individual risk factors. Ideal CVH is associated with a reduced incidence of CKD. Measurements of cumCVH are more likely to reflect the lifetime risk of CKD and possibly of other health outcomes.
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Affiliation(s)
- Jinhong Hou
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Jinjie Huang
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Chunhong Lu
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Jing Zhou
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Yang Liu
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
- * E-mail: (ALJ); (SLW)
| | - Fang Wei
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
| | - Lihua Wang
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
| | - Haiyan Chen
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
| | - Haibo Yu
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
| | - Zhe Wang
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
| | - Aili Jiang
- Kidney disease and blood purification department, The Second Hospital of Tianjin medical university, Tianjin, China
- * E-mail: (ALJ); (SLW)
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Enserro DM, Vasan RS, Xanthakis V. Twenty-Year Trends in the American Heart Association Cardiovascular Health Score and Impact on Subclinical and Clinical Cardiovascular Disease: The Framingham Offspring Study. J Am Heart Assoc 2018; 7:e008741. [PMID: 29773573 PMCID: PMC6015351 DOI: 10.1161/jaha.118.008741] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/19/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Data on the temporal trends in ideal cardiovascular health (CVH) as well as on their association with subclinical/overt cardiovascular disease (CVD) and death are limited. METHODS AND RESULTS This study included 3460 participants attending ≥1 of 4 consecutive exams of the Framingham Heart Study (1991-2008, mean age 55.4 years, CVH score ranged 0-14). We created 4 groups describing changes in CVH score between examination cycles 5 and 8, using first and last exams attended (high-high: starting CVH score ≥8, last score of ≥8, referent; high-low: ≥8 start and ≤7 last; low-high: ≤7 start and ≥8 last; and low-low: ≤7 start and ≤7 last) and related them to subclinical CVD cross-sectionally, and incident CVD and death. Fewer people have ideal CVH scores over the past 20 years (8.5% for 1991-1995, 5.9% for 2005-2008, P=0.002), because of decreases in those with ideal status of body mass index, blood glucose, and serum cholesterol levels (P<0.05 for all). The odds of subclinical disease and risk of CVD and death were higher for all compared with the high-high group (428 CVD and 367 death events, median follow-up 5.1 years, hazard ratios for CVD: 1.39, 1.73, 1.9 and death: 1.12, 1.57, 1.4 and odds ratios for subclinical disease: 1.61, 1.98, 2.86 for high-low, low-high, and low-low, respectively). CONCLUSIONS The decreased presence of ideal CVH scores over the past 20 years resulted in increasing odds of subclinical disease and risk of CVD and death, emphasizing the importance of maintaining ideal CVH over the life course.
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Affiliation(s)
- Danielle M Enserro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Ramachandran S Vasan
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
- Sections of Preventive Medicine & Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Vanessa Xanthakis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
- Sections of Preventive Medicine & Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA
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15
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García-Hermoso A, Martínez-Vizcaíno V, Gomez-Marcos MÁ, Cavero-Redondo I, Recio-Rodriguez JI, García-Ortiz L. Ideal Cardiovascular Health and Arterial Stiffness in Spanish Adults—The EVIDENT Study. J Stroke Cerebrovasc Dis 2018; 27:1386-1394. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.12.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/27/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022] Open
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Wang YQ, Wang CF, Zhu L, Yuan H, Wu LX, Chen ZH. Ideal cardiovascular health and the subclinical impairments of cardiovascular diseases: a cross-sectional study in central south China. BMC Cardiovasc Disord 2017; 17:269. [PMID: 29047374 PMCID: PMC5648483 DOI: 10.1186/s12872-017-0697-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/10/2017] [Indexed: 01/13/2023] Open
Abstract
Background Ideal cardiovascular health (CVH) is related to a low cardiovascular disease risk profile. This study aimed to investigate CVH metrics with both the biomarkers and markers of subclinical impairments of cardiovascular diseases (CVDs) in subjects from central south China. Methods The ideal CVH score (non-smoking status; ideal body mass index; regular physical activity; healthy diet; and an optimal serum cholesterol, blood pressure, and glucose profile; 1 point for each; total score: 0–7) was collected from 3009 participants without a history of CVDs. Subclinical biomarkers were assessed using C-reactive protein, homocysteine, and microalbuminuria. The presence of subclinical disease markers was defined as having at least one of the following: increased carotid intima-media thickness, carotid plaque, left ventricular hypertrophy, left ventricular systolic dysfunction, or a reduced ankle-brachial index. The association of biomarkers and markers with the CVH score was evaluated using multivariate logistic regression and linear regression analyses. Results Only 0.2% of the study participants met all 7 ideal CVH metrics (CVH score = 7). Compared to the female participants, the male participants had poorer CVH profiles and a higher incidence of subclinical lesions (P < 0.05). In the fully adjusted models, per 1-unit increase in the CVH score was inversely associated with the biomarker levels (β = -0.092 – -0.224, P < 0.05 for all) and the odds of the presence of markers (odds ratio, 0.808; 95% confidence interval, 0.755–0.865). Similar relationships were observed in the gender subgroups and were stronger in the females. Conclusion A clear inverse association was observed between the biomarkers or markers of subclinical impairments and the CVH score in a central south Chinese population, implying the importance of ideal CVH for the primordial prevention of CVDs. Electronic supplementary material The online version of this article (10.1186/s12872-017-0697-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ya-Qin Wang
- Department of Health Management Centre, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, Hunan Province, 410013, China
| | - Chang-Fa Wang
- Department of General Surgery, the Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Ling Zhu
- Department of Health Management Centre, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, Hunan Province, 410013, China
| | - Hong Yuan
- Department of Clinical Pharmacology Centre, the Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Liu-Xin Wu
- Zhongguancun Xinzhiyuan Health Management Institute, Beijing, China
| | - Zhi-Heng Chen
- Department of Health Management Centre, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, Hunan Province, 410013, China.
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Zheng X, Zhang R, Liu X, Zhao H, Liu H, Gao J, Wu Y, Wu S. Association between cumulative exposure to ideal cardiovascular health and arterial stiffness. Atherosclerosis 2017; 260:56-62. [DOI: 10.1016/j.atherosclerosis.2017.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/10/2017] [Accepted: 03/10/2017] [Indexed: 01/19/2023]
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18
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Fang N, Jiang M, Fan Y. Ideal cardiovascular health metrics and risk of cardiovascular disease or mortality: A meta-analysis. Int J Cardiol 2016; 214:279-83. [DOI: 10.1016/j.ijcard.2016.03.210] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/27/2016] [Indexed: 11/25/2022]
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19
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Guo L, Guo X, Chang Y, Li Z, Yu S, Yang H, Sun Y. Modified Ideal Cardiovascular Health Status is Associated with Lower Prevalence of Stroke in Rural Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:207. [PMID: 26861368 PMCID: PMC4772227 DOI: 10.3390/ijerph13020207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/03/2016] [Indexed: 01/01/2023]
Abstract
Background: In 2010, the American Heart Association developed a new definition of ideal cardiovascular health (CVH) based on seven cardiovascular health metrics. This study aimed to investigate the relationship between modified ideal CVH metrics and the risk of stroke in the rural population of Northeast China. Methods: We included 11,417 adults from the rural population in Northeast China and collected all the information, including the baseline characteristics, history of stroke, and the seven ideal CVH metrics. Results: Our results showed that the presence of stroke was associated with high body mass index (BMI), poor diet score (salt intake), high total cholesterol (TC), high blood pressure (BP), and high fasting plasma glucose (FPG). The prevalence of stroke increased as the number of ideal CVH metrics decreased, and peaked to 13.1% among those with only one ideal CVH metric. Participants with only one ideal CVH had a 4.40-fold increased susceptibility of stroke than those with all seven ideal health metrics. Conclusion: This study revealed that people with a better CVH status had a lower prevalence of stroke and the susceptibility of stroke increased with the decreasing of the number of ideal CVH metrics.
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Affiliation(s)
- Liang Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
| | - Ye Chang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
| | - Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110000, China.
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