Wu Shouling, Huang Zhengrong, Yang Xinchun, Zhou Yong, Wang Anxing, Chen Li, Zhao Haiyan, Ruan Chunyu, Wu Yuntao, Xin Aijun, Li Kuibao, Jin Cheng, Cai Jun
Department of Cardiology, Hebei United University, Tangshan, China.
Circ Cardiovasc Qual Outcomes. 2012 Jul 1;5(4):487-93. doi: 10.1161/CIRCOUTCOMES.111.963694. Epub 2012 Jul 10.
The American Heart Association Committee recently developed definitions of "ideal," "intermediate," and "poor" cardiovascular health based on 7 cardiovascular disease (CVD) risk factors or health behaviors. This study evaluated the prevalence of "ideal" American Heart Association cardiovascular health metrics from June 2006 to October 2007 in the Kailuan cohort (n=101 510; age 18-98 years) in northern China and its relationship with the 4-year CVD incidence.
We used Cox proportional hazards regression to calculate hazard ratios and 95% confidence intervals for baseline health behaviors and risk factor categories. The majority of participants (63,676; 69.45%) presented with ≤3 ideal cardiovascular health metrics, whereas 8342 participants (9.1%) had 5 to 7 ideal metrics. Only 93 of 91,698 participants (0.1%) had all 7 metrics in the ideal range. There was a strong relationship between the cumulative incidence of CVD events in the 4-year follow-up and the number of ideal health metrics at baseline; the 1111 participants with 6 and 7 ideal metrics had a significantly lower cumulative incidence of CVD than subjects with no or only 1 ideal health metric (0.8% versus 3.3%). Men had higher rates of CVD events than women (2.46% versus 1.18%).
Few adults had ideal cardiovascular health according to the modified American Heart Association definition. We detected a strong inverse relationship between the cumulative CVD incidence and the number of ideal health metrics at baseline. Population-wide prevention, especially lifestyle improvement, is critical to increase the low-risk prevalence and thereafter decrease CVD events. Clinical Trial Registration- URL: http://www.chictr.org/cn/proj/show.aspx?proj=1441. Unique identifier: ChiCTR-TNC-11001489.
美国心脏协会委员会最近基于7种心血管疾病（CVD）危险因素或健康行为制定了“理想”“中等”和“较差”心血管健康的定义。本研究评估了2006年6月至2007年10月在中国北方开滦队列（n = 101510；年龄18 - 98岁）中“理想”的美国心脏协会心血管健康指标的患病率及其与4年CVD发病率的关系。
我们使用Cox比例风险回归来计算基线健康行为和危险因素类别的风险比及95%置信区间。大多数参与者（63676人；69.45%）的理想心血管健康指标≤3项，而8342名参与者（9.1%）有5至7项理想指标。在91698名参与者中，只有93人（0.1%）的所有7项指标都处于理想范围。4年随访期间CVD事件的累积发病率与基线时理想健康指标的数量之间存在密切关系；1111名有6项和7项理想指标的参与者的CVD累积发病率明显低于没有或只有1项理想健康指标的受试者（0.8%对3.3%）。男性的CVD事件发生率高于女性（2.46%对1.18%）。
根据美国心脏协会修改后的定义，很少有成年人拥有理想的心血管健康状况。我们发现CVD累积发病率与基线时理想健康指标的数量之间存在强烈的负相关关系。全人群预防，尤其是改善生活方式，对于提高低风险患病率并进而减少CVD事件至关重要。临床试验注册 - URL：http://www.chictr.org/cn/proj/show.aspx?proj=1441。唯一标识符：ChiCTR - TNC - 11001489。
