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Association between ideal cardiovascular health and markers of subclinical cardiovascular disease
Author(s) -
Shpilsky Daniel,
Bambs Claudia,
Kip Kevin,
Patel Sanjay,
Aiyer Aryan,
Olafiranye Oladipupo,
Reis Steven E.,
Erqou Sebhat
Publication year - 2018
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23096
Subject(s) - medicine , agatston score , reactive hyperemia , framingham risk score , odds ratio , subclinical infection , coronary artery disease , confidence interval , intima media thickness , marital status , cardiology , cardiovascular health , population , disease , coronary artery calcium , carotid arteries , vasodilation , environmental health
Background Ideal cardiovascular health (CVH) was proposed by the American Heart Association to promote population health. We aimed to characterize the association between ideal CVH and markers of subclinical cardiovascular disease (CVD). Hypothesis We hypothesized that ideal CVH is associated with several markers of subclinical CVD. Methods We used data from the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study. We assigned 1 for each of the ideal CVH factors met. Endothelial function, expressed as Framingham reactive hyperemia index (fRHI), was measured using the EndoPAT device. Coronary artery calcium (CAC) and carotid intima‐media thickness (CIMT) were quantified using electron beam computed tomography and carotid ultrasonography, respectively. Results A total of 1933 participants (mean [SD] age: 59 [7.5] years, 34% male, 44% black) were included. The mean number of ideal CVH factors met was 2.3 ± 1.3, with blacks having significantly lower score compared to whites (2.0 ± 1.2 vs 2.5 ± 1.4, respectively; P < 0.001). Seven hundred and eighty‐nine participants (41%) achieved ≥3 ideal CVH factors. Participants with ≥3 ideal CVH factors (compared to those with <3 factors) had an average of 107 (95% confidence interval [CI]: 50‐165) Agatston units lower CAC, 0.04 (0.01‐0.06) mm lower CIMT, and 0.07 (0.02‐0.12) units higher fRHI, after adjusting for age, sex, race, income, education, and marital status. Participants with ≥3 ideal CVH factors had 50% lower odds (95% CI: 28%‐66%) of having CAC >100 Agatston units. Conclusion In a community‐based study with low prevalence of ideal CVH, even achieving three or more ideal CVH factors were associated with lower burden of subclinical CVD, indicating the utility of this construct for disease prevention.

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