title: Cardiovascular health metrics and all-cause and cardiovascular disease mortality among middle-aged men in Korea: the Seoul male cohort study.
abstract: OBJECTIVE
  This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea.
  
  
  METHODS
  In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics.
  
  
  RESULTS
  There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality.
  
  
  CONCLUSIONS
  Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Ko
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Rhee
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Korea Institute of Drug Safety and Risk Management, Seoul, Korea.
authors.forename: Byung-Joo
authors.initials: BJ
authors.lastname: Park
authors.affiliation: Department of Social Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Dong-Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Cheju National University College of Medicine, Jeju, Korea.
authors.forename: Jong-Myon
authors.initials: JM
authors.lastname: Bae
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea.
authors.forename: Myung-Hee
authors.initials: MH
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, Ulsan University College of Medicine, Seoul, Korea.
authors.forename: Moo-Song
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Epidemiology and Statistics, School of Public Health Sciences, Jilin University, Changchun, China.
authors.forename: Zhong Min
authors.initials: ZM
authors.lastname: Li
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Korean Foundation for Cancer Research, Seoul, Korea.
authors.forename: Yoon-Ok
authors.initials: YO
authors.lastname: Ahn
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking
chemical_list: D001786:Blood Glucose
keywords: Cardiovascular diseases; Cohort studies; Cox proportional hazards models; Life style; Mortality