School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Kuopio , Finland.
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol , Bristol , UK.
Ann Med. 2019 Aug-Sep;51(5-6):306-313. doi: 10.1080/07853890.2019.1639808. Epub 2019 Jul 12.
The burden of cardiovascular disease (CVD) prompted the American Heart Association to develop a cardiovascular health (CVH) metric as a measure to assess the cardiovascular status of the population. We aimed to assess the association between CVH scores and the risk of CVD mortality among a middle-aged Finnish population. We employed the prospective population-based Kuopio Ischemic Heart Disease cohort study comprising of middle-aged men (42-60 years). CVH scores were computed among 2607 participants at baseline and categorized as optimum (0-4), average (5-9), or inadequate (10-14) CVH. Multivariate cox regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of CVH score for cardiovascular mortality. During a median follow-up period of 25.8 years, 609 CVD mortality cases were recorded. The risk of CVD mortality increased gradually with increasing CVH score across the range 3-14 (-value for non-linearity =.77). Men with optimum CVH score had HR (95% CI) for CVD mortality of 0.30 (CI 0.21 - 0.42, < .0001) compared to those with inadequate CVH score after adjustment for conventional cardiovascular risk factors. CVH score was strongly and continuously associated with the risk of CVD mortality among middle-aged Finnish population and this was independent of other conventional risk factors. Key messages Achieving optimum cardiovascular health score reduces the risk of cardiovascular mortality. Adopting the American Heart Association's cardiovascular health metrics is a welcome approach for public health awareness and monitoring of cardiovascular health among Scandinavian population.
心血管疾病（CVD）负担促使美国心脏协会开发了心血管健康（CVH）指标，作为评估人群心血管状况的一种衡量标准。我们旨在评估 CVH 评分与中年芬兰人群 CVD 死亡率风险之间的关联。
我们采用前瞻性基于人群的库奥皮奥缺血性心脏病队列研究，其中包括中年男性（42-60 岁）。在基线时对 2607 名参与者计算 CVH 评分，并将其分为最佳（0-4 分）、平均（5-9 分）或不足（10-14 分）CVH。使用多变量 Cox 回归模型估计 CVH 评分与心血管死亡率的风险比（HR）和 95%置信区间（CI）。
在中位数为 25.8 年的随访期间，记录了 609 例 CVD 死亡病例。随着 CVH 评分从 3 到 14 分的增加，CVD 死亡率的风险逐渐增加（-值非线性性=.77）。与不足的 CVH 评分相比，具有最佳 CVH 评分的男性的 CVD 死亡率 HR（95%CI）为 0.30（CI 0.21-0.42， < .0001），调整了传统心血管危险因素后。
CVH 评分与中年芬兰人群 CVD 死亡率风险之间存在强烈且持续的关联，这与其他传统危险因素无关。
主要发现
达到最佳心血管健康评分可降低心血管死亡率风险。采用美国心脏协会的心血管健康指标是提高斯堪的纳维亚人群对心血管健康的公众意识和监测的一种受欢迎的方法。
