Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city.
BACKGROUND
The American Heart Association Committee recently developed definitions of "ideal," "intermediate," and "poor" cardiovascular health based on 7 cardiovascular disease (CVD) risk factors or health behaviors. This study evaluated the prevalence of "ideal" American Heart Association cardiovascular health metrics from June 2006 to October 2007 in the Kailuan cohort (n=101 510; age 18-98 years) in northern China and its relationship with the 4-year CVD incidence.


RESULTS
We used Cox proportional hazards regression to calculate hazard ratios and 95% confidence intervals for baseline health behaviors and risk factor categories. The majority of participants (63,676; 69.45%) presented with ≤3 ideal cardiovascular health metrics, whereas 8342 participants (9.1%) had 5 to 7 ideal metrics. Only 93 of 91,698 participants (0.1%) had all 7 metrics in the ideal range. There was a strong relationship between the cumulative incidence of CVD events in the 4-year follow-up and the number of ideal health metrics at baseline; the 1111 participants with 6 and 7 ideal metrics had a significantly lower cumulative incidence of CVD than subjects with no or only 1 ideal health metric (0.8% versus 3.3%). Men had higher rates of CVD events than women (2.46% versus 1.18%).


CONCLUSIONS
Few adults had ideal cardiovascular health according to the modified American Heart Association definition. We detected a strong inverse relationship between the cumulative CVD incidence and the number of ideal health metrics at baseline. Population-wide prevention, especially lifestyle improvement, is critical to increase the low-risk prevalence and thereafter decrease CVD events. Clinical Trial Registration- URL: http://www.chictr.org/cn/proj/show.aspx?proj=1441. Unique identifier: ChiCTR-TNC-11001489.
Department of Cardiology, Hebei United University, Tangshan, China.
Shouling
S
Wu
Zhengrong
Z
Huang
Xinchun
X
Yang
Yong
Y
Zhou
Anxing
A
Wang
Li
L
Chen
Haiyan
H
Zhao
Chunyu
C
Ruan
Yuntao
Y
Wu
Aijun
A
Xin
Kuibao
K
Li
Cheng
C
Jin
Jun
J
Cai
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D044466:Asian People / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D014504:Urban Health / Q000208:ethnology*; D055815:Young Adult