title: Ideal Cardiovascular Health and Incident Cardiovascular Events: The Jackson Heart Study.
abstract: The epidemiology of American Heart Association ideal cardiovascular health (CVH) metrics has not been fully examined in African Americans. This study examines the associations of CVH metrics with incident cardiovascular disease (CVD) in the Jackson Heart Study, a longitudinal cohort study of CVD in African Americans.
  
  
  
  Jackson Heart Study participants without CVD (n=4,702) were followed prospectively between 2000 and 2011. Incidence rates and Cox proportional hazard ratios estimated risks for incident CVD (myocardial infarction, stroke, cardiac procedures, and CVD mortality) associated with seven CVH metrics by sex. Analyses were performed in 2015.
  
  
  
  Participants were followed for a median of 8.3 years; none had ideal health on all seven CVH metrics. The prevalence of ideal health was low for nutrition, physical activity, BMI, and blood pressure metrics. The age-adjusted CVD incidence rate (IR) per 1,000 person years was highest for individuals with the least ideal health metrics: zero to one (IR=12.5, 95% CI=9.7, 16.1), two (IR=8.2, 95% CI=6.5, 10.4), three (IR=5.7, 95% CI=4.2, 7.6), and four or more (IR=3.4, 95% CI=2.0, 5.9). Adjusting for covariates, individuals with four or more ideal CVH metrics had lower risks of incident CVD compared with those with zero or one ideal CVH metric (hazard ratio, 0.29; 95% CI=0.17, 0.52; p<0.001).
  
  
  
  African Americans with more ideal CVH metrics have lower risks of incident CVD. Comprehensive preventive behavioral and clinical supports should be intensified to improve CVD risk for African Americans with few ideal CVH metrics.
authors.affiliation: Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ommerborn
authors.affiliation: Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Chad T
authors.initials: CT
authors.lastname: Blackshear
authors.affiliation: Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper, Inc., Jackson, Mississippi; Department of Epidemiology and Biostatistics, Jackson State University, Jackson, Mississippi.
authors.forename: DeMarc A
authors.initials: DA
authors.lastname: Hickson
authors.affiliation: Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Griswold
authors.affiliation: Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Japneet
authors.initials: J
authors.lastname: Kwatra
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Division of Aging, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Boston VA Healthcare System, Boston, Massachusetts;
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
authors.affiliation: Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of General Medicine and Primary Care, Brigham and Women's Faulkner Hospitalist Program, Boston, Massachusetts. Electronic address: crclark@partners.org.
authors.forename: Cheryl R
authors.initials: CR
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology