title: A Systematic Review of the Prevalence and Outcomes of Ideal Cardiovascular Health in US and Non-US Populations.
abstract: Several population-based studies have examined the prevalence and trends of the American Heart Association's ideal cardiovascular health (CVH) metrics as well as its association with cardiovascular disease (CVD)-related morbidity and mortality and with non-CVD outcomes. However, no efforts have been made to aggregate these studies. Accordingly, we conducted a systematic review to synthesize available data on the distribution and outcomes associated with ideal CVH metrics in both US and non-US populations. We conducted a systematic search of relevant studies in the MEDLINE and CINAHL databases, as well as the Cochrane Register of Controlled Trials (CENTRAL). Search terms used included "life's simple 7", "AHA 2020" and "ideal cardiovascular health". We included articles published in English Language from January 1, 2010, to July 31, 2015. Of the 14 US cohorts, the prevalence of 6 to 7 ideal CVH metrics ranged from as low as 0.5% in a population of African Americans to 12% in workers in a South Florida health care organization. Outside the United States, the lowest prevalence was found in an Iranian study (0.3%) and the highest was found in a large Chinese corporation (15%). All 6 mortality studies reported a graded inverse association between the increasing number of ideal CVH metrics and the all-cause and CVD-related mortality risk. A similar relationship between ideal CVH metrics and incident cardiovascular events was found in 12 of 13 studies. Finally, an increasing number of ideal CVH metrics was associated with a lower prevalence and incidence of non-CVD outcomes such as cancer, depression, and cognitive impairment. The distribution of ideal CVH metrics in US and non-US populations is similar, with low proportions of persons achieving 6 or more ideal CVH metrics. Considering the strong association of CVH metrics with both CVD and non-CVD outcomes, a coordinated global effort for improving CVH should be considered a priority.
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Adnan
authors.initials: A
authors.lastname: Younus
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL; Department of Internal Medicine, Mount Sinai Medical Center, Miami, FL.
authors.forename: Ehimen C
authors.initials: EC
authors.lastname: Aneni
authors.affiliation: The Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT.
authors.forename: Erica S
authors.initials: ES
authors.lastname: Spatz
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
authors.forename: Chukwuemeka U
authors.initials: CU
authors.lastname: Osondu
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Lara
authors.initials: L
authors.lastname: Roberson
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
authors.forename: Oluseye
authors.initials: O
authors.lastname: Ogunmoroti
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Rehan
authors.initials: R
authors.lastname: Malik
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Shozab S
authors.initials: SS
authors.lastname: Ali
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Aziz
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Theodore
authors.initials: T
authors.lastname: Feldman
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
authors.affiliation: Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
authors.forename: Wasim
authors.initials: W
authors.lastname: Maziak
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Agatston
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
authors.forename: Emir
authors.initials: E
authors.lastname: Veledar
authors.affiliation: Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL; Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD; Miami Cardiac and Vascular Institute, Miami, FL. Electronic address: KhurramN@baptisthealth.net.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
mesh_terms: D000572:American Heart Association; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D002320:Cardiovascular Physiological Phenomena; D002423:Cause of Death; D003072:Cognition Disorders / Q000453:epidemiology / Q000517:prevention & control; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control; D004032:Diet / Q000592:standards*; D015444:Exercise / Q000502:physiology*; D014943:Global Health / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014481:United States / Q000453:epidemiology