Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
J Am Heart Assoc. 2018 Feb 3;7(3):e007234. doi: 10.1161/JAHA.117.007234.
The relationship between ideal cardiovascular health reflected in the cardiovascular health score (CVHS) and valvular heart disease is not known. The purpose of this study was to determine the association of CVHS attainment through midlife to late life with aortic stenosis prevalence and severity in late life.
The following 6 ideal cardiovascular health metrics were assessed in ARIC (Atherosclerosis Risk in Communities) Study participants at 5 examination visits between 1987 and 2013 (visits 1-4 in 1987-1998 and visit 5 in 2011-2013): smoking, body mass index, total cholesterol, blood pressure, physical activity, and blood glucose. Percentage attained CVHS was calculated in 6034 participants as the sum of CVHS at each visit/the maximum possible score. Aortic stenosis was assessed by echocardiography at visit 5 on the basis of the peak aortic valve velocity. Aortic stenosis was categorized sclerosis, mild stenosis, and moderate-to-severe stenosis. Mean age was 76±5 years, 42% were men, and 22% were black. Mean percentage attained CVHS was 63±14%, and the prevalence of aortic stenosis stages were 15.9% for sclerosis, 4.3% for mild stenosis, and 0.7% for moderate-to-severe stenosis. Worse percentage attained CVHS was associated with higher prevalence of aortic sclerosis (<0.001 for trend), mild stenosis (<0.001), and moderate-to-severe stenosis (=0.002), adjusting for age, sex, and race.
Greater attainment of ideal cardiovascular health in midlife to late life is associated with a lower prevalence of aortic sclerosis and stenosis in late life in a large cohort of older adults.
心血管健康评分（CVHS）反映的理想心血管健康状况与瓣膜性心脏病之间的关系尚不清楚。本研究旨在确定从中年到晚年获得 CVHS 与晚年主动脉瓣狭窄患病率和严重程度的关系。
在 ARIC（社区动脉粥样硬化风险）研究参与者中，评估了以下 6 项理想心血管健康指标，这些参与者在 1987 年至 2013 年的 5 次检查访问中进行了评估（1987-1998 年的访问 1-4 和 2011-2013 年的访问 5）：吸烟、体重指数、总胆固醇、血压、身体活动和血糖。在 6034 名参与者中计算了获得 CVHS 的百分比，方法是将每次访问的 CVHS 总和除以最大可能分数。在访问 5 时，根据峰值主动脉瓣速度通过超声心动图评估主动脉瓣狭窄。主动脉瓣狭窄分为硬化、轻度狭窄和中重度狭窄。平均年龄为 76±5 岁，42%为男性，22%为黑人。平均获得 CVHS 的百分比为 63±14%，主动脉瓣狭窄各阶段的患病率分别为硬化 15.9%、轻度狭窄 4.3%和中重度狭窄 0.7%。获得 CVHS 的百分比越低，主动脉瓣硬化的患病率越高（趋势<0.001）、轻度狭窄（趋势<0.001）和中重度狭窄（趋势=0.002），调整年龄、性别和种族后。
从中年到晚年获得更多的理想心血管健康与老年人群中晚期主动脉瓣硬化和狭窄的患病率降低相关。
