Polonsky Tamar S, Ning Hongyan, Daviglus Martha L, Liu Kiang, Burke Gregory L, Cushman Mary, Eng John, Folsom Aaron R, Lutsey Pamela L, Nettleton Jennifer A, Post Wendy S, Sacco Ralph L, Szklo Moyses, Lloyd-Jones Donald M
Department of Medicine, University of Chicago, IL
Department of Preventive Medicine, Northwestern University, Chicago, IL.
J Am Heart Assoc. 2017 Mar 20;6(3):e004894. doi: 10.1161/JAHA.116.004894.
Few adults have ideal cardiovascular health (CVH). We studied associations of an overall CVH score with subclinical cardiovascular disease and events. We assessed whether associations varied by race/ethnicity.
Among 5961 participants in the Multi-Ethnic Study of Atherosclerosis, components of CVH were measured at baseline, 2000-2002: systolic blood pressure, total cholesterol, fasting glucose, smoking, physical activity, diet, and body mass index. Levels were classified as ideal (2 points), intermediate (1 point), and poor (0 points) according to American Heart Association definitions. Points were summed to produce a CVH score (0-7 low, 8-11 moderate, 12-14 high). Coronary artery calcium, carotid intima-media thickness, and left ventricular mass were measured at baseline. Cardiovascular disease was defined as myocardial infarction, coronary heart disease death, resuscitated cardiac arrest, stroke, heart failure, or peripheral artery disease. Follow-up was 10.3 years. Regression models were used to examine associations of the CVH score with subclinical disease and events, adjusting for age, sex, and education. Analyses were stratified by race/ethnicity. Adults with high or moderate CVH scores had significantly lower odds of coronary artery calcium and lower carotid intima-media thickness and left ventricular mass than adults with low CVH scores. Adults with high or moderate CVH scores were 67% (95%CI 41% to 82%) and 37% (95%CI 22% to 49%) less likely, respectively, to experience a cardiovascular disease event than adults with low scores. There was no interaction with race/ethnicity.
There is a graded inverse association between CVH scores and measures of subclinical and overt cardiovascular disease that is similar across race/ethnic groups.
很少有成年人拥有理想的心血管健康（CVH）。我们研究了整体CVH评分与亚临床心血管疾病及事件之间的关联。我们评估了这些关联是否因种族/族裔而异。
在动脉粥样硬化多族裔研究的5961名参与者中，于2000 - 2002年基线时测量了CVH的组成部分：收缩压、总胆固醇、空腹血糖、吸烟、身体活动、饮食和体重指数。根据美国心脏协会的定义，将水平分为理想（2分）、中等（1分）和差（0分）。将分数相加得出CVH评分（0 - 7分为低，8 - 11分为中等，12 - 14分为高）。在基线时测量冠状动脉钙化、颈动脉内膜中层厚度和左心室质量。心血管疾病定义为心肌梗死、冠心病死亡、复苏的心脏骤停、中风、心力衰竭或外周动脉疾病。随访时间为10.3年。使用回归模型来检验CVH评分与亚临床疾病及事件之间的关联，并对年龄、性别和教育程度进行了调整。分析按种族/族裔进行分层。与CVH评分低的成年人相比，CVH评分高或中等的成年人冠状动脉钙化的几率显著更低，颈动脉内膜中层厚度和左心室质量也更低。与CVH评分低的成年人相比，CVH评分高或中等的成年人发生心血管疾病事件的可能性分别低67%（95%CI 41%至82%）和37%（95%CI 22%至49%）。不存在与种族/族裔的交互作用。
CVH评分与亚临床和显性心血管疾病指标之间存在分级的负相关，且在不同种族/族裔群体中相似。
