Chang Ye, Li Yuan, Guo Xiaofan, Li Tan, Chen Yintao, Dai Dongxue, Sun Yingxian
Department of Cardiology Department of Cardiovascular Ultrasound, the First Hospital of China Medical University, Shenyang, People's Republic of China.
Medicine (Baltimore). 2017 Feb;96(6):e6050. doi: 10.1097/MD.0000000000006050.
In 2010, the American Heart Association (AHA) published a new concept "ideal cardiovascular health" (CVH), which consisted of 4 behaviors (smoking, body mass index [BMI], physical activity, and diet score) and 3 health factors (total cholesterol [TC], blood pressure [BP], and fasting plasma glucose [FPG]). This study was aimed to investigate the association between CVH with left ventricle hypertrophy (LVH) in a rural general population.From January 2012 to August 2013, we conducted this cross-sectional study using a multi-stage cluster sampling method. A representative sample of individuals who were at 35 years or older was selected. All the 7 CVH metrics were estimated for ideal, intermediate, and poor levels. LVH was accessed by echocardiography and classified into concentric remodeling, concentric LVH, and eccentric LVH. The association between CVH and LVH was determined.The final data were obtained from 10,684 adults (5497 men and 5187 women) in the rural areas of northeast China. Overall, the prevalence rates of concentric remodeling, concentric LVH, and eccentric LVH were 5.1%, 4.9%, and 12.8%, respectively. The prevalence of concentric/eccentric LVH was inversely related to the numbers of ideal CVH metrics. Multivariate logistic regression analysis indicated that only poor BP was associated with concentric remodeling among the 7 CVH metrics; poor BP was highly associated with concentric LVH (OR: 8.49; 95% CI: 4.59-15.7); poor BMI was highly associated with eccentric LVH (OR: 5.87; 95% CI: 4.83-7.14). Compared to subjects with 5 to 7 ideal CVH metrics, subjects with 4, 3, 2, 1, and 0 ideal CVH metrics had an increased risk for both concentric and eccentric LVH in a number-dependent manner. The subjects with poor CVH status had a 5.90-fold higher risk of developing concentric LVH and a 3.24-fold higher risk of developing eccentric LVH, compared to subjects with ideal-intermediate CVH.Our study found that an inversely gradient relationship existed between the prevalence of concentric/eccentric LVH with the numbers of ideal CVH metrics. Although not all the 7 CVH metrics were associated with LVH, the components of CVH metrics carried a synergistic effect beyond the risk related to the component alone.
2010年，美国心脏协会（AHA）发布了一个新的概念“理想心血管健康”（CVH），它由4种行为（吸烟、体重指数[BMI]、身体活动和饮食评分）和3种健康因素（总胆固醇[TC]、血压[BP]和空腹血糖[FPG]）组成。本研究旨在调查农村普通人群中CVH与左心室肥厚（LVH）之间的关联。2012年1月至2013年8月，我们采用多阶段整群抽样方法进行了这项横断面研究。选取了35岁及以上具有代表性的个体样本。对所有7项CVH指标进行了理想、中等和较差水平的评估。通过超声心动图评估LVH，并将其分为向心性重构、向心性LVH和离心性LVH。确定了CVH与LVH之间的关联。最终数据来自中国东北地区农村的10684名成年人（5497名男性和5187名女性）。总体而言，向心性重构、向心性LVH和离心性LVH的患病率分别为5.1%、4.9%和12.8%。向心性/离心性LVH的患病率与理想CVH指标的数量呈负相关。多因素逻辑回归分析表明，在7项CVH指标中，只有较差的血压与向心性重构有关；较差的血压与向心性LVH高度相关（比值比：8.49；95%置信区间：4.59 - 15.7）；较差的BMI与离心性LVH高度相关（比值比：5.87；95%置信区间：4.83 - 7.14）。与具有5至7项理想CVH指标的受试者相比，具有4、3、2、1和0项理想CVH指标的受试者发生向心性和离心性LVH的风险均以数量依赖的方式增加。与具有理想 - 中等CVH的受试者相比，CVH状况较差的受试者发生向心性LVH的风险高5.90倍，发生离心性LVH的风险高3.24倍。我们的研究发现，向心性/离心性LVH的患病率与理想CVH指标的数量之间存在反向梯度关系。虽然并非所有7项CVH指标都与LVH相关，但CVH指标的各组成部分具有协同作用，其风险超过了单个组成部分相关的风险。
