Association of ideal cardiovascular health and calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study.
BACKGROUND
The American Heart Association (AHA) established recommendations based on 7 ideal health behaviors and factors with the goal of improving cardiovascular health (CVH) and reducing both morbidity and mortality from cardiovascular disease by 20% by 2020. Few studies have investigated their association with subclinical coronary heart disease. We sought to examine whether the 7 AHA CVH metrics were associated with calcified atherosclerotic plaque in the coronary arteries.


METHODS
In a cross-sectional design, we studied 1,731 predominantly white men and women from the National Heart, Lung, and Blood Institute Family Heart Study without prevalent coronary heart disease. Diet was assessed by a semiquantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac computed tomography. We defined prevalent CAC using an Agatston score of 100+ and fitted generalized estimating equations to calculate prevalence odds ratios of CAC.


RESULTS
Mean age was 56.8 years, and 41% were male. The median number of ideal CVH metrics was 3, and no participant met all 7. There was a strong inverse relationship between number of ideal CVH metrics and prevalent CAC. Odds ratios (95% CI) for CAC of 100+ were 1.0 (reference), 0.37 (0.29-0.45), 0.35 (0.26-0.44), and 0.27 (0.20-0.36) among subjects with 0 to 1, 2, 3, and 4+ ideal CVH metrics, respectively (P = .0001), adjusting for sex, age, field center, alcohol, income, education, and energy consumption.


CONCLUSIONS
These data demonstrate a strong and graded inverse relationship between AHA ideal CVH metrics and prevalent CAC in adult men and women.
Division of Internal Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA. Electronic address: jrobbins3@partners.org.
Jeremy M
JM
Robbins
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Andrew B
AB
Petrone
Department of Radiology, Vanderbilt University, Nashville, TN.
J Jeffrey
JJ
Carr
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
James S
JS
Pankow
Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT.
Steven C
SC
Hunt
Department of Epidemiology, School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC.
Gerardo
G
Heiss
Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL.
Donna K
DK
Arnett
Section of Preventive Medicine & Epidemiology, Boston University, Boston, MA.
R Curtis
RC
Ellison
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA.
J Michael
JM
Gaziano
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA.
Luc
L
Djoussé
D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology; D002320:Cardiovascular Physiological Phenomena; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000453:epidemiology; D061205:Vascular Calcification / Q000473:pathology*
D001786:Blood Glucose