Laitinen Tomi T, Pahkala Katja, Magnussen Costan G, Oikonen Mervi, Viikari Jorma S A, Sabin Matthew A, Daniels Stephen R, Heinonen Olli J, Taittonen Leena, Hartiala Olli, Mikkilä Vera, Hutri-Kähönen Nina, Laitinen Tomi, Kähönen Mika, Raitakari Olli T, Juonala Markus
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health University of Turku, Turku, Finland.
Int J Cardiol. 2015 Apr 15;185:186-91. doi: 10.1016/j.ijcard.2015.03.051. Epub 2015 Mar 5.
The American Heart Association recently defined 7 ideal health behaviors and factors that can be used to monitor ideal cardiovascular health (ICH) over time. These relate to smoking, physical activity, diet, body mass index (BMI), blood pressure, blood glucose and total cholesterol. Associations between repeated measures of ICH across the life-course with outcomes of subclinical atherosclerosis in adult life have not been reported.
The sample comprised 1465 children and young adults aged 12 to 24 years (mean age 17.5 years) from the Cardiovascular Risk in Young Finns Study cohort. Participants were followed-up for 21 years since baseline (1986) and had complete ICH data available at baseline and follow-up. Average lifetime ICH index was associated with reduced risk of coronary artery calcification (CAC) (P=0.0004), high-risk carotid intima-media thickness (IMT) (P=0.0005) and high-risk carotid distensibility (<0.0001) in middle age. Participants with persistently low ICH status (lower than the median), as compared with persons with persistently high ICH status (higher than the median), had an increased risk of CAC (P=0.02), high-risk IMT (P=0.02), and high-risk distensibility (P<0.0001). Participants who improved their ICH status from low to high did not have a different risk of CAC (P=0.90), high-risk IMT (P=0.25), or high-risk distensibility (P=0.80) than participants who always had high ICH status.
The results show that ICH can be lost and regained, and importantly that regaining of ICH has a beneficial effect on cardiometabolic health. Health care providers should work to improve health behaviors especially in those who have lost ICH.
美国心脏协会最近定义了7种理想的健康行为和因素，可用于长期监测理想心血管健康（ICH）。这些与吸烟、身体活动、饮食、体重指数（BMI）、血压、血糖和总胆固醇有关。目前尚未报道成年期亚临床动脉粥样硬化结局与生命历程中重复测量的ICH之间的关联。
样本包括来自芬兰年轻人心血管风险研究队列的1465名12至24岁（平均年龄17.5岁）的儿童和年轻人。自基线（1986年）起对参与者进行了21年的随访，基线和随访时均有完整的ICH数据。中年时，平均终生ICH指数与冠状动脉钙化（CAC）风险降低（P = 0.0004）、高危颈动脉内膜中层厚度（IMT）（P = 0.0005）和高危颈动脉扩张性降低（P<0.0001）相关。与ICH状态持续较高（高于中位数）的人相比，ICH状态持续较低（低于中位数）的参与者患CAC（P = 0.02）、高危IMT（P = 0.02）和高危扩张性（P<0.0001）的风险增加。从低ICH状态改善到高ICH状态的参与者与始终处于高ICH状态的参与者相比，患CAC（P = 0.90）、高危IMT（P = 0.25）或高危扩张性（P = 0.80）的风险没有差异。
结果表明，ICH可以丧失和恢复，重要的是恢复ICH对心脏代谢健康有有益影响。医疗保健提供者应努力改善健康行为，尤其是在那些ICH丧失的人群中。
