Ideal cardiovascular health metrics and its association with 20-year cardiovascular morbidity and mortality in a Chinese population

Background The American Heart Association (AHA) developed a simplified assessment tool based on seven ideal cardiovascular health (CVH) metrics, but the relationship between the AHA defined ideal CVH metrics and cardiovascular risk in Chinese population has not been well estimated. Methods The baseline survey were conducted among 938 Chinese men and women from four urban and rural population samples in China, aged 35-59 years in 1983-1984. The cohort was followed up for multiple cardiovascular endpoints up to 2005. Cox proportional hazard models were used to test the associations accounting for multiple covariates. Outcomes were collected in 1987-2005 and data analysed in 2017. Results During a median of 20.3 years follow-up, 68 non-fatal CVD events and 139 deaths (29 CVD deaths) occurred. The multivariable adjusted HRs and 95% CIs for all CVD in the groups with three and 4-7 ideal CVH metrics were 0.59 (95% CI 0.33 to 1.04) and 0.24 (95% CI 0.12 to 0.47), when the group with 0-2 ideal CVH metrics as the reference. Results also showed that participants with 4-7 ideal CVH metrics had a 54% (95% CI 24% to 72%) lower risk of all-cause mortality in comparison with those with 0-2 ideal metrics. Conclusions The number of ideal CVH metrics was inversely associated with the risk of cardiovascular morbidity and mortality in this Chinese general population.