Department of Kinesiology and Health Science, Emma Eccles Jones College of Education and Human Services, Utah State University, 7000 Old Main Hill, Logan, UT, 84322, USA.
School of Business, Innovation, Leadership and Technology and Marymount Center for Optimal Aging, Marymount University, USA.
Public Health. 2023 May;218:60-67. doi: 10.1016/j.puhe.2023.02.014. Epub 2023 Mar 23.
Cardiovascular health is the leading cause of death and disability in the United States. Our objective was to estimate the association between ideal cardiovascular health (ICVH) and multiple disabilities among US adults stratified into the three age groups of young (18-44 years), midlife (45-64 years), and older adults (≥65 years).
We conducted a cross-sectional analysis using data pooled from the 2017 and 2019 Behavioral Risk Factor Surveillance System (BRFSS).
Using American Heart Association's seven-component (four ideal behaviors and three ideal health factors) scoring tool, we identified ICVH as a composite score ≥5 and also computed the ideal behavioral (score ≥3) and ideal health factors (score = 3) submetrics. The outcome, single vs multiple disabilities indicator, was defined using US Census's disability domains and analyzed using multinomial regression.
For all three groups, the prevalence of multiple disabilities was significantly lower among those meeting ICVH, ideal behavioral, and ideal health factors compared with those that did not. After controlling for covariates, ICVH score ≥5 was associated with lower relative risk of multiple disabilities in all groups. Although both ideal health and ideal behavioral factors were associated with lower relative risk of multiple disabilities among all groups, the reduction in risk was the highest for multiple disabilities and ideal behavioral factors among midlife (relative risk ratio: 0.30, 95% confidence interval: 0.25, 0.36) and older adults (relative risk ratio: 0.40, 95% confidence interval: 0.33, 0.48).
Adults with less-than-ideal cardiovascular health had a higher relative risk of multiple disabilities. Addressing the risk of multiple disabilities of US adults will require effective promotion of ICVH.
心血管健康是美国死亡和残疾的主要原因。我们的目的是评估理想心血管健康（ICVH）与美国成年人多种残疾之间的关系，并将其分为三个年龄组：年轻人（18-44 岁）、中年人（45-64 岁）和老年人（≥65 岁）。
我们使用 2017 年和 2019 年行为风险因素监测系统（BRFSS）的数据进行了横断面分析。
使用美国心脏协会的七项指标（四项理想行为和三项理想健康因素）评分工具，我们将 ICVH 定义为复合评分≥5，还计算了理想行为（评分≥3）和理想健康因素（评分=3）的亚指标。使用美国人口普查的残疾领域定义了单一与多种残疾指标，并使用多项回归进行分析。
在所有三个年龄段中，与不符合 ICVH、理想行为和理想健康因素的人相比，符合这些标准的人多种残疾的患病率显著降低。在控制了协变量后，ICVH 评分≥5 与所有年龄段的多种残疾的相对风险降低相关。虽然理想健康和理想行为因素都与所有年龄段的多种残疾的相对风险降低相关，但在中年人（相对风险比：0.30，95%置信区间：0.25，0.36）和老年人（相对风险比：0.40，95%置信区间：0.33，0.48）中，多种残疾和理想行为因素的风险降低幅度最高。
心血管健康状况不佳的成年人发生多种残疾的相对风险较高。要降低美国成年人的多种残疾风险，需要有效促进 ICVH。
