Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Expert Rev Cardiovasc Ther. 2021 Jul;19(7):607-617. doi: 10.1080/14779072.2021.1937127. Epub 2021 Jun 15.
The American Heart Association (AHA) introduced the construct of 'cardiovascular health (CVH)', to focus on primordial prevention to reduce the burden of cardiovascular disease (CVD). The CVH score includes seven health and behavioral metrics (smoking, physical activity, body mass index, diet, total cholesterol, blood pressure, blood glucose), which are characterized as being ideal, intermediate, or poor.
In this review, we describe the utility of the CVH score for monitoring and promoting wellness, overall and by key sociodemographic groups, and for tracking of temporal trends.
Notably, the seven factors are all modifiable, which differs from 10-year CVD risk scores that include non-modifiable components such as age, sex, and race. Numerous epidemiological studies have shown that achievement of a greater number of ideal CVH metrics is associated with lower incidences of CVD, cardiovascular mortality, and all-cause mortality. Longer duration of favorable CVH is associated with greater longevity and compressed morbidity. Nevertheless, the prevalence of favorable CVH is low, with <20% of U.S. adults meeting ≥5 metrics at ideal levels and significant racial/ethnic disparities persist. Many challenges must be overcome to improve CVH at individual and societal levels if the AHA Impact Goals are to be fully realized.
美国心脏协会（AHA）引入了“心血管健康（CVH）”的概念，旨在关注初级预防，以减轻心血管疾病（CVD）的负担。CVH 评分包括七个健康和行为指标（吸烟、身体活动、体重指数、饮食、总胆固醇、血压、血糖），这些指标的特征是理想、中等或差。
在这篇综述中，我们描述了 CVH 评分在监测和促进整体和关键社会人口群体的健康、以及跟踪时间趋势方面的效用。
值得注意的是，这七个因素都是可改变的，这与包括不可改变的因素（如年龄、性别和种族）的 10 年 CVD 风险评分不同。许多流行病学研究表明，实现更多理想的 CVH 指标与 CVD、心血管死亡率和全因死亡率的发生率降低相关。较长时间的有利 CVH 与更高的寿命和压缩发病率相关。然而，有利的 CVH 患病率较低，在美国成年人中只有<20%达到≥5 个指标的理想水平，并且仍然存在显著的种族/民族差异。如果要充分实现 AHA 影响目标，就必须在个人和社会层面上克服许多挑战，以提高 CVH。
