The First affiliated hospital, Sun Yat-Sen University, CN.
NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, CN.
Glob Heart. 2023 Mar 17;18(1):14. doi: 10.5334/gh.1179. eCollection 2023.
The benefits of reaching ideal cardiovascular health (CVH) are well known, but it is unclear whether positive CVH changes from young adulthood to middle age reduce subclinical atherosclerosis risk. This study examined associations of changes in CVH from young adulthood to middle age and CVH in young adulthood with subclinical atherosclerosis.
Data was analyzed from the Coronary Artery Risk Development in Young Adults (CARDIA) study. CVH was examined at years 0 and 20 using Life Simple 7 metrics from AHA guideline. Coronary artery calcium (CAC) was identified at years 20 and 25. Carotid intima-media thickness (IMT) was identified at year 20.
Among 2,935 participants (56.2% women, 46.7% black), the change of CVH score was -1.26 (2.13). For per 1-unit increase in CVH at baseline, the adjusted odds ratios (ORs) of presence of CAC and IMT were 0.81 (95% CI 0.78, 0.86) and 0.85 (95% CI 0.76, 0.94), respectively. For per 1-unit increase in CVH changes, the adjusted ORs of CAC and IMT were 0.86 (95% CI 0.82, 0.90) and 0.81 (95% CI 0.73, 0.90). Compared with stable moderate CVH, improvement from moderate to high was associated with a lower risk of CAC (0.64 [95% CI 0.43, 0.96]), while retrogression from moderate to low was associated with a higher risk of CAC (1.45 [95% CI 1.19, 1.76]).
Positive changes of CVH during young adulthood are associated with negative subclinical atherosclerosis risk in middle age, indicating the importance of reaching an ideal cardiovascular health status through young adulthood.
众所周知，达到理想的心血管健康（CVH）有很多好处，但目前尚不清楚从青年到中年 CVH 状况的积极变化是否会降低亚临床动脉粥样硬化的风险。本研究旨在探讨青年期到中年期 CVH 变化以及青年期 CVH 与亚临床动脉粥样硬化的关系。
该研究数据来自冠状动脉风险发展（CARDIA）研究。使用美国心脏协会指南中的 Life Simple 7 指标，分别在研究的第 0 年和第 20 年评估 CVH。在第 20 年和第 25 年评估冠状动脉钙（CAC）。在第 20 年评估颈动脉内膜中层厚度（IMT）。
在 2935 名参与者中（56.2%为女性，46.7%为黑人），CVH 评分变化为-1.26（2.13）。与基线时 CVH 每增加 1 个单位相比，CAC 和 IMT 存在的校正比值比（OR）分别为 0.81（95%可信区间 0.78，0.86）和 0.85（95%可信区间 0.76，0.94）。与 CVH 变化每增加 1 个单位相比，CAC 和 IMT 的校正 OR 分别为 0.86（95%可信区间 0.82，0.90）和 0.81（95%可信区间 0.73，0.90）。与稳定的中等 CVH 相比，从中度改善到高度与 CAC 风险降低相关（0.64 [95%可信区间 0.43，0.96]），而从中度下降到低度与 CAC 风险升高相关（1.45 [95%可信区间 1.19，1.76]）。
青年期 CVH 的积极变化与中年亚临床动脉粥样硬化风险呈负相关，这表明通过青年期达到理想的心血管健康状态非常重要。
