Cardiovascular Health Score and the Risk of Cardiovascular Diseases

Miao, Congliang; Bao, Minghui; Xing, Aijun; Chen, Shuohua; Wu, Yuntao; Cai, Jun; Chen, Youren; Yang, Xinchun

doi:10.1371/journal.pone.0131537

Cited by 48 publications

(40 citation statements)

References 25 publications

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“…Numerous studies have established that higher numbers of ideal LS7 metrics or higher LS7 scores are strongly associated with favorable outcomes 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14. Our results are comparable to the findings of prior studies that have shown an inverse relationship between higher LS7 scores and the incidence of non‐CVD 15, 16, 17, 18, 19.…”

Section: Discussionsupporting

confidence: 86%

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Association Between Life's Simple 7 and Noncardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Allen

Cushman

et al. 2016

JAHA

107

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BackgroundThe American Heart Association introduced the Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health. We examined the association between the LS7 metrics and noncardiovascular disease.Methods and ResultsWe studied 6506 men and women aged between 45 and 84 years, enrolled in the Multi‐Ethnic Study of Atherosclerosis. Median follow‐up time was 10.2 years. Each component of the LS7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was assigned points, 0 indicates “poor” category; 1, “intermediate,” and 2, “ideal.” The LS7 score, ranged from 0 to 14, was created from the points and categorized as optimal (11–14), average (9–10), and inadequate (0–8). Hazard ratios and event rates per 1000 person‐years were calculated for outcomes based on self‐reported hospitalizations with the International Classification of Diseases, 9th Revision, diagnoses of cancer, chronic kidney disease, pneumonia, deep venous thromboembolism/pulmonary embolism, chronic obstructive pulmonary disease, dementia, and hip fracture. Analyses were adjusted for age, sex, race/ethnicity, income, and education. Overall, noncardiovascular disease event rates were lower with increasing LS7 scores. With the inadequate LS7 score as reference, an optimal score was associated with a decreased risk for noncardiovascular disease events. The hazard ratio for cancer was, 0.80 (0.64–0.98); chronic kidney disease, 0.38 (0.27–0.54); pneumonia, 0.57 (0.40–0.80); deep venous thromboembolism/pulmonary embolism, 0.52 (0.33–0.82), and chronic obstructive pulmonary disease, 0.51 (0.31–0.83).ConclusionsThe American Heart Association's LS7 score identified individuals who were vulnerable to multiple chronic nonvascular conditions. These results suggest that improving cardiovascular health will also reduce the burden of cancer and other chronic diseases.

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Section: Discussionsupporting

confidence: 86%

“…These 7 health behaviors and factors have been termed Life's Simple 7 (LS7) metrics 4. The inverse relationship between ideal CVH and CVD incidence is well documented 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14. However, research exploring the association between ideal CVH and non‐CVDs has just begun 15, 16, 17, 18, 19…”

Section: Introductionmentioning

confidence: 99%

Association Between Life's Simple 7 and Noncardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Allen

Cushman

et al. 2016

JAHA

107

View full text Add to dashboard Cite

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“…The nearly 1‐point difference in CVH score would be expected to translate into disparities in incident CVD in the future. Each 1 point greater on the 14‐point CVH scale has been associated with 18% lower risk of developing stroke or myocardial infarction in a multiracial sample 25. As previous studies have noted, if CVH trends continue without rapid improvement, prevention goals will go unmet 15, 26.…”

Section: Discussionmentioning

confidence: 90%

Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

Pool

Ning

Lloyd‐Jones

et al. 2017

JAHA

156

105

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BackgroundIn the United States, there are persistent racial and ethnic disparities in cardiovascular disease morbidity and mortality. National efforts have focused on reducing these disparities; however, little is known about the long‐term trends in racial/ethnic disparities in cardiovascular health (CVH).Methods and ResultsWe included 11 285 adults aged ≥20 years from the National Health and Nutrition Examination Surveys survey cycles 1999/2000 through 2011/2012. CVH includes 7 health factors and behaviors—diet, physical activity, smoking status, body mass index, blood pressure, blood glucose, and total cholesterol—each scored as ideal (2 points), intermediate (1 point), or poor (0 points). Overall CVH is a summation of these scores (range, 0–14) points. Age‐adjusted mean CVH scores were calculated by race/ethnicity (non‐Hispanic black, non‐Hispanic white, or Mexican American) and sex for each survey cycle. Non‐Hispanic black women had significantly lower mean CVH scores as compared with non‐Hispanic white women at each survey cycle (difference=0.93; P=0.001 in 2011/2012) and Mexican‐American women had significantly lower mean score as compared with non‐Hispanic white women at almost all survey cycles (difference=0.71; P=0.02 in 2011/2012). Differences between racial/ethnic groups were smaller for men and were mostly nonsignificant.ConclusionsFrom 1999/2000 to 2011/2012, there were enduring disparities in CVH for non‐Hispanic black and Mexican‐American women as compared with non‐Hispanic white women. Disparities that were present in 1999/2000 were present in 2011/2012, though no racial/ethnic differences became more pronounced over time. These findings provide US nationally representative data to evaluate health factors and behaviors of particular concern regarding racial/ethnic disparities in cardiovascular health.

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“…3 Several multiethnic cohorts have examined AHA CVH prevalence and associated incident CVD by race. 4–7 The Northern Manhattan Study (NOMAS), Atherosclerosis Risk in Communities Study (ARIC), and Reasons for Geographic and Racial Difference in Stroke cohorts found increased CVD and stroke risk associated with a lower number of ideal CVH risk factors among African American participants. 5–7 The relation between AHA CVH and incident CVD has not been examined in the JHS, the largest single-site, prospective epidemiologic cohort of African Americans in the U.S.…”

Section: Introductionmentioning

confidence: 99%

Ideal Cardiovascular Health and Incident Cardiovascular Events

Ommerborn

Blackshear

Hickson

et al. 2016

American Journal of Preventive Medicine

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Introduction The epidemiology of American Heart Association ideal cardiovascular health (CVH) metrics has not been fully examined in African Americans. This study examines associations of CVH metrics with incident cardiovascular disease (CVD) in the Jackson Heart Study, a longitudinal cohort study of CVD in African Americans. Methods Jackson Heart Study participants without CVD (N=4,702) were followed prospectively between 2000 and 2011. Incidence rates and Cox proportional hazard ratios estimated risks for incident CVD (myocardial infarction, stroke, cardiac procedures, and CVD mortality) associated with seven CVH metrics by sex. Analyses were performed in 2015. Results Participants were followed for a median 8.3 years; none had ideal health on all seven CVH metrics. The prevalence of ideal health was low for nutrition, physical activity, BMI, and blood pressure metrics. The age-adjusted CVD incidence rate (IR) per 1,000 person years was highest for individuals with the least ideal health metrics: zero to one (IR=12.5, 95% CI=9.7, 16.1), two (IR=8.2, 95% CI=6.5, 10.4), three (IR=5.7, 95% CI=4.2, 7.6), and four or more (IR=3.4, 95% CI=2.0, 5.9). Adjusting for covariates, individuals with four or more ideal CVH metrics had lower risks of incident CVD compared with those with zero or one ideal CVH metric (hazard ratio, 0.29; 95% CI=0.17, 0.52; p<0.001). Conclusions African Americans with more ideal CVH metrics have lower risks of incident CVD. Comprehensive preventive behavioral and clinical supports should be intensified to improve CVD risk for African Americans with few ideal CVH metrics.

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Cardiovascular Health Score and the Risk of Cardiovascular Diseases

Cited by 48 publications

References 25 publications

Association Between Life's Simple 7 and Noncardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

Association Between Life's Simple 7 and Noncardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

Ideal Cardiovascular Health and Incident Cardiovascular Events

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