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Influential Periods in Longitudinal Clinical Cardiovascular Health Scores.

ABSTRACT: The prevalence of ideal cardiovascular health (CVH) among adults in the United States is low, and decreases with age. Our objective was to identify specific age windows when the loss of CVH accelerates, to ascertain preventive opportunities for intervention. This study pools data from five longitudinal cohorts (Project Heartbeat!, Cardiovascular Risk in Young Finns Study, The Bogalusa Heart Study, Coronary Artery Risk Development in Young Adults (CARDIA), Special Turku Coronary Risk Factor Intervention Project (STRIP)) from the United States and Finland from 1973 to 2012. Individuals with clinical CVH factors (body mass index, blood pressure, cholesterol, blood glucose) measured between ages 8 to 55 were included. These factors were categorized and summed into a clinical CVH score ranging from 0 (worst) to 8 (best). Adjusted segmented linear mixed models were used to estimate the change in CVH over time. Among the 18,343 participants, 9461(52%) were female and 12,346(67%) White. The baseline mean (SD) clinical CVH score was 6.9(1.2) at an average age of 17.6(8.1). Two inflection points were estimated, at 16.9 years (95% CI: 16.4, 17.4) and at 37.2 years (95% CI: 32.4, 41.9). Late adolescence and early middle age appear to be influential periods at which the loss of CVH accelerates.

SUBMITTER: Krefman AE

PROVIDER: S-EPMC8561125 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe American Heart Association recommends Life's Simple 7 as ideal cardiovascular health (ICVH) to reduce cardiovascular risk. Rate advancement period (RAP), a useful tool to quantify and communicate exposure impact on risks, may enhance communication about the benefits of achieving ICVH. We aimed to examine whether greater adherence to ICVH metrics was associated with reduced incidence of cardiovascular risk in a population-based cohort and estimate its impact on the timing of occurrence using RAP.MethodsProspective analyses of 3826 participants, initially free from cardiovascular disease at baseline, enrolled in the Vascular Risk in Navarra Study (RIVANA), a Mediterranean population-based cohort of Spanish adults. ICVH metrics were defined using participants' baseline information as follows: never-smoker or quitting > 12 months ago, body mass index < 25 kg/m2, ≥ 150 min/week of moderate physical activity or equivalent, healthy dietary pattern (≥ 9 points on a validated 14-item Mediterranean diet adherence screener), untreated cholesterol < 200 mg/dL, untreated blood pressure < 120/80 mmHg, and untreated fasting blood glucose < 100 mg/dL. Participants were assigned 1 point for each achieved metric and were grouped according to their number of accumulated metrics in ≤ 2, 3, 4, and ≥ 5. The primary endpoint was major cardiovascular events (composite of myocardial infarction, stroke, or death from cardiovascular causes). Cox proportional hazard ratios (HRs) and RAPs with their corresponding 95% confidence intervals (95% CI) adjusted for potential confounders were calculated.ResultsDuring a median follow-up of 12.8 years (interquartile range 12.3-13.1), a total of 194 primary endpoints were identified. Compared to participants with ≤ 2 ideal metrics, HR (95% CI) for major cardiovascular events among participants meeting ≥ 5 metrics was 0.32 (0.17-0.60) with RAP (95% CI) of - 14.4 years (- 22.9, - 5.9).ConclusionsGreater adherence to ICVH metrics was associated with lower cardiovascular risk among Spanish adults of the RIVANA cohort. Adherence to ideal metrics may substantially delay cardiovascular risk.

Project description:PurposeObesity is a significant risk factor for cardiovascular disease; however, the impact of weight loss on cardiovascular health (CVH) in individuals with specific obesity patterns remains incompletely understood. The objective of our study was to investigate the relationship weight loss percentage and CVH scores across individuals with various obesity patterns.MethodsOur study utilized data from the National Health and Nutrition Examination Survey conducted between 2007 and 2018, involving a total of 12,835 participants aged 16 years or older, to conduct a cross-sectional analysis. Multiple linear regression and multinomial logistic regression methods were used to assess the correlation between the weight loss percentage and the CVH scores. Additionally, restricted cubic spline analysis was employed to examine the nonlinear relationship between the two variables.ResultsCompared to individuals with a weight loss percentage < 0%, participants with weight loss percentages of 0-5% and 5.1-10% showed improved CVH scores, with β values of 2.85 (95% CI 2.32-3.38) and 2.55 (95% CI 1.69-3.4), respectively. Regarding different obesity patterns, compared to participants with a weight loss percentage < 0%, participants with a weight loss percentage of 0-5% showed an increase in CVH scores in the normal weight and overweight/general obesity (OGO) groups, with β values of 1.45 (95% CI 0.7-2.19) and 1.22 (95% CI 0.46-1.97), respectively. Restricted cubic spline analysis revealed a significant inverted U-shaped relationship between the weight loss percentage and the CVH scores (with optimal CVH scores at 3%).ConclusionsThere was an inverted U-shaped relationship between weight loss percentage and CVH scores, with moderate weight loss (0-10%, optimal value of 3%) being associated with improved CVH scores, especially among individuals with OGO.Level vOpinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

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Influential Periods in Longitudinal Clinical Cardiovascular Health Scores.

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