农村南非人群的理想心血管健康指数及其决定因素。
Ideal Cardiovascular Health Index and Its Determinants in a Rural South African Population.
机构信息
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, NL.
Ezintsha, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA.
出版信息
Glob Heart. 2020 Nov 25;15(1):76. doi: 10.5334/gh.801.
BACKGROUND
The ideal cardiovascular health index (CVHI) is a measure to summarize cardiovascular (CV) health, and includes smoking, body-mass index, physical activity, blood pressure, glucose, total cholesterol, and diet.
OBJECTIVE
This study aimed to assess CV health using the CVHI and determinants on CV health in a rural African population, and correlate carotid intima-media thickness (CIMT), a surrogate marker for atherosclerosis, with CVHI.
METHODS
A cross-sectional analysis was performed on baseline data of the Ndlovu Cohort Study, located in rural South Africa. CVHI score (CVHIs) was calculated by the sum of favourable CVHI factors (range 0 to 7). Logistic regression was performed to examine the association of age, sex, HIV-status, education level, employment status, and income with good CV health (5-7 favourable health factors). Mean CIMT was displayed by poor, intermediate and good CV health.
RESULTS
The study included 1927 participants with a mean age of 38.7 years (SD ± 12.8). Of the factors contributing to the CVHI, glucose and total cholesterol scored best; diet least good. Average CVHIs for the population was 4.4 (SD ± 1.2) and 53% of the population had a good CV health. Determinants associated with good CV health were younger age, higher educational attainment, and HIV positivity. CVHIs showed good agreement with CIMT.
CONCLUSION
CVHIs showed that more than half of the participants had a good CV health. Agreement between CVHIs and CIMT indicates potential use of CVHIs as a surrogate marker for CV risk. The study highlights the importance of education for health promotion; good CV health in HIV-positive participants may in part be attributed to more frequent health care contact and provision of chronic disease care.
HIGHLIGHTS
Good cardiovascular health (CVH) was observed in 53% of the study population.In global comparison, rural African study participants showed a good CVH score.HIV positivity was associated with a good CVH score.CVH score showed good agreement with carotid intima-media thickness.
背景
理想心血管健康指数（CVHI）是一种综合心血管健康的衡量标准，包括吸烟、体重指数、身体活动、血压、血糖、总胆固醇和饮食。
目的
本研究旨在评估农村非洲人群的 CVHI 和 CV 健康决定因素，并将颈动脉内膜中层厚度（CIMT）作为动脉粥样硬化的替代标志物与 CVHI 相关联。
方法
对位于南非农村的 Ndlovu 队列研究的基线数据进行了横断面分析。CVHI 评分（CVHIs）通过有利的 CVHI 因素（范围 0 到 7）的总和计算。使用逻辑回归检查年龄、性别、HIV 状态、教育程度、就业状况和收入与良好 CV 健康（5-7 个有利健康因素）的相关性。显示了不良、中等和良好 CV 健康的平均 CIMT。
结果
研究共纳入 1927 名参与者，平均年龄为 38.7 岁（标准差 ± 12.8）。在 CVHI 的构成因素中，血糖和总胆固醇得分最高；饮食最差。人群的平均 CVHIs 为 4.4（标准差 ± 1.2），53%的人群具有良好的 CV 健康。与良好 CV 健康相关的决定因素是年龄较小、教育程度较高和 HIV 阳性。CVHIs 与 CIMT 具有良好的一致性。
结论
CVHIs 表明，超过一半的参与者具有良好的 CV 健康。CVHIs 与 CIMT 的一致性表明，CVHIs 可能作为 CV 风险的替代标志物。该研究强调了教育对促进健康的重要性；HIV 阳性参与者的良好 CV 健康在一定程度上可能归因于更频繁的医疗保健接触和提供慢性疾病护理。
重点
研究人群中有 53%的人具有良好的心血管健康（CVH）。在全球范围内比较，农村非洲研究参与者的 CVH 评分较高。HIV 阳性与良好的 CVH 评分相关。CV 评分与颈动脉内膜中层厚度具有良好的一致性。
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