Usefulness of the American Heart Association's Ideal Cardiovascular Health Measure to Predict Long-term Major Adverse Cardiovascular Events (From the Heart SCORE Study)

• Published in: The American journal of cardiology Vol. 138; pp. 20 - 25
• Main Authors: Nguyen, Anh Thy H., Saeed, Anum, Bambs, Claudia E., Swanson, Justin, Emechebe, Nnadozie, Mansuri, Fahad, Talreja, Karan, Reis, Steven E., Kip, Kevin E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2021; Elsevier Limited
• Subjects: Acute Coronary Syndrome - epidemiology; Age; Aged; American Heart Association; Blood Glucose - metabolism; Blood Pressure; Body mass; Body Mass Index; Body size; Cardiovascular disease; Cardiovascular diseases; Cerebral infarction; Cholesterol; Cholesterol - blood; Confidence intervals; Demographics; Demography; Diet - statistics & numerical data; Estimates; Exercise; Fasting; Female; Gender; Glucose; Heart; Heart Disease Risk Factors; Heart diseases; Humans; Hypertension; Ischemia; Male; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - epidemiology; Myocardial Revascularization - statistics & numerical data; Nutrition research; Physical activity; Population studies; Proportional Hazards Models; Quality of life; Questionnaires; Race; Regression analysis; Risk analysis; Risk Assessment; Risk factors; Smoking - epidemiology; Statistical analysis; Stroke; Stroke - epidemiology; United States - epidemiology; United States
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2020.10.019

To further reduce the burden of cardiovascular disease (CVD) and expand prevention efforts, the American Heart Association (AHA) introduced in 2010 the concept of Ideal Cardiovascular Health (ICH), which includes 7 metrics (smoking status, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose). Limited data exist on the relation between ICH and long-term CVD risk. The Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study cohort was used to examine the relation between ICH and incident major adverse cardiovascular events (MACE: first occurrence of death, myocardial infarction, stroke, acute ischemic syndrome, or coronary revascularization). The 7 factors of the ICH were scored at study entry on a 0 to 2 scale, resulting in possible range of 0 to 14, with higher scores representing “better” health. Cox regression analyses were used to estimate hazard ratios (HR) of MACE, along with 95% confidence intervals. Over a median follow-up of 12 years, the study population (n = 1,863, 67% women, 42% Black race, mean age 59 years [range 45 to 75]) had 218 MACE. In unadjusted analysis, the ICH score (per 1 unit) was associated with an estimated 12% lower risk of MACE (HR [95% Confidence Interval]: 0.88 [0.82, 0.93]). Adjusting for demographics, education, and quality of life, ICH score was associated with a 10% lower risk of MACE (HR 0.90 [0.84, 0.96]). In a community-based sample of adults, the AHA ICH construct, which includes 7 modifiable CVD risk factors, appears to be a valid measure for predicting long-term risk of MACE.