Number of AHA cardiovascular metrics linked to mortality
MedWire News: The number of cardiovascular health metrics is a strong predictor for all-cause and cardiovascular (CV) mortality, an American Heart Association (AHA) study suggests.
Individuals who met five of seven CV health metrics outlined by the AHA had significantly lower all-cause and CV mortality than those who met none of the metrics, report Earl Ford (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) and co-authors in Circulation.
"These data, which are consistent with the results from a recent prospective study, suggest that attainment of the AHA 2020 goals could result in substantial reductions in mortality," they write.
The AHA 2020 Impact Goal is to improve the CV health of all Americans by 20% and reduce CV mortality by 20%.
To achieve these goals, the AHA have set out seven components of CV health, including four ideal behaviors - not smoking, body mass index (BMI) of less than 25 kg/m2, physical activity at goal levels, and diet that includes three or more daily servings of fruit and vegetables - and three factors - total cholesterol of less than 200 mg/dL, systolic blood pressure of less than 120 mmHg and diastolic blood pressure of less than 80 mmHg, and a fasting plasma glucose level of less than 100 mg/dL.
The team used data from 7622 adults aged at least 20 years who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002, whose mortality data through 2006 was linked to the National Death Index.
Overall, only 1.0% of participants met all seven metrics of CV health, 13.8% met five of the seven metrics, 5.4% met six metrics, while 1.5% met none.
Over a median follow-up period of 5.8 years, 532 deaths occurred, including 186 CV deaths. There was a significant inverse relationship between all-cause and CV mortality with increasing number of CV metrics.
Compared with participants who had none of the metrics, those with five or more had a significant 78% lower risk for all-cause mortality and 88% lower risk for CV mortality. The results remained significant after excluding patients who died in the first year of follow-up and patients with CV disease.
"Our analyses using the NHANES 1999-2002 data show that only a small percentage of US adults met ideal criteria for all seven CV health metrics, a result that is disappointing but perhaps not surprising," write the authors.
"The challenge for clinical and public health professionals is to keep moving the distribution of the number of health metrics in the desired direction."
They conclude: "Other studies are needed to examine the relationships between the AHA 2020 goals and the incidence and mortality of CV disease.
"Examining these relationships in historical as well as in more current cohorts will provide important feedback about the choice of metrics as well as the selected definitions for poor, intermediate, and ideal health."
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By Piriya Mahendra