Kaneko Fumie, Lee Hokyou, Shim Jee-Seon, Kim Hyeon Chang
Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea.
Division of Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Clin Hypertens. 2025 May 1;31:e16. doi: 10.5646/ch.2025.31.e16. eCollection 2025.
The distribution of cardiovascular health (CVH) and its association with vascular health among Asian adolescents is understudied. We examined the distribution of optimal CVH metrics and their association with carotid intima-media thickness (cIMT) in Korean adolescents.
We analyzed data from a cohort of 694 healthy Korean adolescents with an average follow-up period of 2.4 years. CVH scores were assessed at baseline and follow-up using 6 metrics from Life's Essential 8 (LE8), excluding diet and sleep. Additionally, we developed an experimental set of 7 metrics by incorporating a psychological health indicator. We examined the association between CVH and cIMT using 2 approaches: 1) aggregated CVH, calculated as the average of the 2 time points, and 2) changes in CVH over time. High cIMT, defined as the highest sex-specific quartile measured at the follow-up visit, was analyzed using multivariable logistic regression.
Among participants (mean age, 15.9 years at baseline), approximately 25% maintained an optimal-level CVH, with physical activity being the most challenging metric. Higher CVH was associated with lower odds of high cIMT; gradually decreasing odds according to higher aggregated CVH were evident. Maintaining optimal CVH resulted in 50% lower odds of high cIMT compared to those with persistently suboptimal CVH. The results remained consistent when the psychological health metric was incorporated into CVH.
Among Korean adolescents, CVH scores for 6 of LE8 metrics, excluding diet and sleep, were comparable to those of non-Hispanic Asian adolescents in the U.S. Higher CVH was associated with lower odds of high cIMT at age 18.
亚洲青少年心血管健康（CVH）的分布及其与血管健康的关联研究不足。我们研究了韩国青少年最佳CVH指标的分布及其与颈动脉内膜中层厚度（cIMT）的关联。
我们分析了694名健康韩国青少年队列的数据，平均随访期为2.4年。在基线和随访时使用生命基本8项（LE8）中的6项指标（不包括饮食和睡眠）评估CVH得分。此外，我们通过纳入一项心理健康指标制定了一组7项指标的实验集。我们使用两种方法研究CVH与cIMT之间的关联：1）汇总CVH，计算为两个时间点的平均值；2）CVH随时间的变化。高cIMT定义为随访时测量的特定性别最高四分位数，使用多变量逻辑回归进行分析。
在参与者中（基线时平均年龄为15.9岁），约25%维持最佳水平的CVH，身体活动是最具挑战性的指标。较高的CVH与高cIMT的较低几率相关；根据较高的汇总CVH，几率逐渐降低是明显的。与持续次优CVH的人相比，维持最佳CVH导致高cIMT的几率降低50%。当将心理健康指标纳入CVH时，结果仍然一致。
在韩国青少年中，LE8中不包括饮食和睡眠的6项指标的CVH得分与美国非西班牙裔亚洲青少年的得分相当。较高CVH与18岁时高cIMT的较低几率相关。
