期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 76, 期 23, 页码 2695-2707出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2020.10.002
关键词
Life's Simple 7; population attributable fraction; primordial prevention
资金
- National Heart, Lung, and Blood Institute (NHLBI)
- University of Alabama at Birmingham [HHSN268201800005I, HHSN268201800007I]
- Northwestern University [HHSN268201800003I]
- University of Minnesota [HHSN268201800006I]
- Kaiser Foundation Research Institute [HHSN268201800004I]
- Johns Hopkins University School of Medicine [HHSN268200900041C]
- NHLBI [K23 HL145101]
- National Institutes of Health/NHLBI
- National Center for Advancing Translational Sciences [KL2TR001424]
- American Heart Association [19TPA34890060]
BACKGROUND When measured in adolescence or young adulthood, cardiovascular health (CVH) is associated with future subclinical cardiovascular disease (CVD), but data are lacking regarding CVD events or mortality. OBJECTIVES This study examined associations of CVH at ages 18 to 30 years with premature CVD and mortality. METHODS This study analyzed data from the CARDIA (Coronary Artery Risk Development in Young Adults Study). CVH was scored at baseline (1985 to 1986) using Life's Simple 7 metrics and categorized as high (12 to 14 points), moderate (8 to 11), or low (0 to 7). CVD events and cause-specific mortality were adjudicated over 32 years of follow-up. Adjusted associations were estimated using Cox models and event rates and population attributable fractions were calculated by CVH category. . RESULTS Among 4,836 participants (mean age: 24.9 years, 54.8% female, 50.5% Black, mean education: 15.2 years), baseline CVH was high (favorable) in 28.8%, moderate in 65.0%, and low in 6.3%. During follow-up, 306 CVD events and 431 deaths occurred. The adjusted hazard ratios for high (vs. low) CVH were 0.14 (95% confidence interval [CI]: 0.09 to 0.22) for CVD and 0.07 (95% CI: 0.03 to 0.19) for CVD mortality, and the population attributable fractions for combined moderate or low (vs. high) CVH were 0.63 (95% CI: 0.47 to 0.74) for CVD and 0.81 (95% CI: 0.55 to 0.92) for CVD mortality. Among individuals with high CVH, event rates were low across sociodemographic subgroups (e.g., CVD rates per 1,000 person-years: age 18 to 24 years, 0.64; age 25 to 30 years, 0.65; men, 1.04; women, 0.36; Blacks, 0.90; Whites, 0.50; up to/through high-school education, 1.00; beyond high-school education, 0.61). CONCLUSIONS High CVH in late adolescence or young adulthood was associated with very low rates of premature CVD and mortality over 32 years, indicating the critical importance of maintaining high CVH. (C) 2020 by the American College of Cardiology Foundation.
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