Pool Lindsay R, Ning Hongyan, Huffman Mark D, Reis Jared P, Lloyd-Jones Donald M, Allen Norrina B
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Prev Med. 2019 Sep;126:105772. doi: 10.1016/j.ypmed.2019.105772. Epub 2019 Jul 16.
Previous studies have linked cardiovascular health (CVH) and health-related quality of life (HRQoL), but only in cross-sectional analyses where temporality cannot be established. The aim of this study was to determine trajectories of CVH from early adulthood to middle age, and examine their association with HRQoL in middle age. This analysis, conducted in 2018, included 3275 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study who completed a year 30 follow-up exam in 2015/2016. Group-based trajectory modeling was used to create CVH trajectories, according to American Heart Association definitions, from baseline through follow-up year 20. HRQoL was assessed by the Medical Outcomes Study 12-Item Short Form Health Survey at year 30, which included the physical component summary score (PCS), the mental component summary score (MCS), and overall self-rated health (SRH). The mean (SD) age of the sample was 55.1 (3.6) years, 1868 (57%) were women, and 1541 (47%) were black. Five CVH trajectories were identified, 31% of CARDIA participants maintained ideal CVH during follow-up. Maintaining ideal CVH was associated with higher PCS and MCS, and lower odds of fair/poor SRH as compared to the other trajectory groups. Compared to the consistently low CVH group, those who maintained ideal CVH had on average a 5.9 point higher PCS (95% CI, 4.2-7.7), a 2.5-point higher MCS (95% CI, 0.5-4.4), and 84% lower odds of fair/poor SRH (95% CI, 0.09, 0.31). Our findings suggest that maintaining ideal CVH from early adulthood results in higher health-related quality of life in middle age.
以往的研究将心血管健康（CVH）与健康相关生活质量（HRQoL）联系起来，但仅限于无法确定时间顺序的横断面分析。本研究的目的是确定从成年早期到中年的心血管健康轨迹，并研究它们与中年时健康相关生活质量的关联。这项于2018年进行的分析纳入了3275名青年成人冠状动脉风险发展研究（CARDIA）的参与者，他们在2015/2016年完成了第30年的随访检查。根据美国心脏协会的定义，采用基于组的轨迹模型从基线到随访第20年创建心血管健康轨迹。在第30年时，通过医学结局研究12项简短健康调查评估健康相关生活质量，该调查包括身体成分汇总得分（PCS）、心理成分汇总得分（MCS）和总体自我评估健康（SRH）。样本的平均（标准差）年龄为55.1（3.6）岁，1868名（57%）为女性，1541名（47%）为黑人。确定了五条心血管健康轨迹，31%的CARDIA参与者在随访期间维持理想的心血管健康。与其他轨迹组相比，维持理想的心血管健康与更高的PCS和MCS以及更低的SRH为一般/差的几率相关。与始终处于低心血管健康组相比，维持理想心血管健康的人平均PCS高5.9分（95%CI，4.2 - 7.7），MCS高2.5分（95%CI，0.5 - 4.4），SRH为一般/差的几率低84%（95%CI，0.09，0.31）。我们的研究结果表明，从成年早期开始维持理想的心血管健康会带来中年时更高的健康相关生活质量。
