Saúde cardiovascular e validação do escore autorreferido no Brasil: uma análise da Pesquisa Nacional de Saúde

Moreira, Alexandra Dias; Gomes, Crizian Saar; Machado, Ísis Eloah; Malta, Déborah Carvalho; Felisbino-Mendes, Mariana Santos

doi:10.1590/1413-812320202511.31442020

Cited by 9 publications

(4 citation statements)

References 26 publications

(29 reference statements)

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“…Fourth, cardiovascular health was determined by self-reported data. Although a recent study showed that self-reported cardiovascular health may represent a reliable and valid alternative to measured cardiovascular health, this may increase the risk of measurement bias. Incorrect assessment of cardiovascular health might lead to an underestimation of the reported associations.…”

Section: Discussionmentioning

confidence: 99%

Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms

et al. 2023

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ImportanceCardiovascular health may be used for prevention of depressive symptoms. However, data on the association of cardiovascular health across midlife with depressive symptoms are lacking.ObjectiveTo evaluate whether better baseline cardiovascular health and improvement of cardiovascular health over time are associated with a lower risk of both incident depressive symptoms and unfavorable trajectories of depressive symptoms.Design, Setting, and ParticipantsParticipants without depressive symptoms were included from a prospective community-based cohort in France (GAZEL cohort). Cardiovascular health examinations occurred in 1990 and 1997 and assessment of depressive symptoms in 1997 and every 3 years thereafter until 2015. Data were analyzed from January to October 2022.ExposuresNumber of cardiovascular health metrics (smoking, body mass index, physical activity, diet, blood pressure, glucose, and cholesterol) at an intermediate or ideal level in 1997 (range, 0-7) and 7-year change in cardiovascular health between 1990 and 1997.Main Outcomes and MeasuresPrimary outcome was incident depressive symptoms (20-item Center for Epidemiologic Studies–Depression Scale [CES-D] score of 17 or greater in men or 23 or greater in women); secondary outcome was trajectories of depressive symptoms scores. Trajectories included consistently low scores, moderately elevated scores, low starting then increasing scores, moderately high starting, increasing, then remitting scores, and moderately high starting then increasing scores.ResultsOf 6980 included patients, 1671 (23.9%) were women, and the mean (SD) age was 53.3 (3.5) years. During a follow-up spanning 19 years after 1997, 1858 individuals (26.5%) had incident depressive symptoms. Higher baseline cardiovascular health in 1997 and improvement in cardiovascular health over 7 years were each associated with lower risk of depressive symptoms (odds ratio [OR] per additional metric at intermediate or ideal level at baseline, 0.87; 95% CI, 0.84-0.91; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.91; 95% CI, 0.86-0.96). Also, better cardiovascular health was associated with lower risk of unfavorable depressive symptoms trajectories. Compared with the consistently low score trajectory, the lowest risks were observed for the low starting then increasing score trajectory (OR per additional metric at intermediate or ideal level at baseline, 0.70; 95% CI, 0.64-0.76; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.73; 95% CI, 0.68-0.79) and the moderately high starting then increasing score trajectory (OR per additional metric at intermediate or ideal level at baseline, 0.71; 95% CI, 0.64-0.79; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.71; 95% CI, 0.64-0.77).Conclusions and RelevanceIn this prospective community-based cohort study of adults, higher cardiovascular health was associated with a lower risk of depressive symptoms over time. Elucidating which set of cardiovascular factors may affect depression risk could be important for prevention.

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Section: Discussionmentioning

confidence: 99%

Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms

et al. 2023

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“…Insufficient surveillance and public awareness of hypercholesterolemia in middle-aged adults may contribute to the lower concordance of the person-centered and measured hypercholesterolemia compared to hypertension and T2D 21 , 22 . So far, only one previous cross-sectional study conducted in 8,943 middle-aged Brazilians has compared person-centered and measured CVH 23 . In that study, the sensitivity and specificity of the person-centered CVH were 92.4 and 48.5%, compared to 93.6 and 72.1% in the current study.…”

Section: Discussionmentioning

confidence: 99%

Person-centered and measured life’s simple 7 cardiovascular health concordance and association with incident cardiovascular disease

Deraz

Sloten

Climie

et al. 2023

Sci Rep

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Person-centered cardiovascular health (CVH) may facilitate cardiovascular disease primordial prevention in low resources settings. The study aims to assess the validity of person-centered CVH compared to gold standard measured CVH by examining the concordance between person-centered vs. measured CVH together with their respective association with incident cardiovascular disease events (CVD). Life’s Simple 7 (LS7) CVH metrics, including non-smoking, Body Mass Index, diet, physical activity, blood glycemia, blood pressure, and blood cholesterol were collected from 19,473 adults participating in the e-cohort NutriNet-Santé study from 2011 to 2014 and were followed until September 2020. Clinical examinations and blood analyses defined the measured biological metrics, while diagnoses, medication, or treatment for type 2 diabetes, hypertension, and hypercholesterolemia defined person-centered biological metrics. Declared behavioral metrics were common for both measured and person-centered CVH. The study included 18,714 CVD-free participants (mean age 51 years, 73% women), among whom 16.52% and 38.75% had 5–7 ideal LS7 metrics according to measured and person-centered CVH, respectively. Weighted concordance of person-centered and measured CVH was 0.87 [0.86; 0.88]. Over median follow-up of 8.05 years, 749 CVD events occurred. There was a 7% (HR 0.93 [0.88; 0.99]) and 13% (HR 0.87 [0.83; 0.92]) risk reduction of CVD risk by additional measured and person-centered ideal metrics, respectively. In conclusion, person-centered CVH may represent a reliable alternative to measured CVH.

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“…However, self-reported data to assess CVH metrics has been used in other studies 20 )-( 22 and has a good correlation with biological measures. 23 Another limitation of this study involves the comparison between subgroups of sociodemographic variables that may not have sufficient number of individuals in some categories, such as race/skin color. As positive points of the study, we highlight (i) the fact that it was performed in a representative sample of the Brazilian adult population and (ii) presented updated data on the prevalence of CVH in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of ideal cardiovascular health in the Brazilian adult population - National Health Survey 2019

Motta

Bousquet-Santos

Motoki

et al. 2023

Epidemiol. Serv. Saúde

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Objective: to analyze the prevalence of ideal cardiovascular health (CVH) in the Brazilian adult population based on the 2019 National Health Survey. Methods: this was a population-based cross-sectional study (n = 77,494); prevalence and respective 95% confidence intervals (95%CI) of ideal CVH (seven metrics achieved simultaneously) and by individual metrics (four behavioral and three biological metrics), as defined by the American Heart Association, were estimated. Results: only 0.5% (95%CI 0.4;0.6) of the study population presented ideal CVH, with higher prevalence among those with higher level of education (1.3%; 95%CI 0.9;1.6) and residents in urban areas (0.6%; 95%CI 0.5;0.7); the prevalence of behavioral and biological metrics was 0.7% (95%CI 0.6;0.8) and 63.3% (95%CI 62.7;63.9) respectively. Conclusion: the prevalence of ideal CVH was very low, highlighting the need for public policies aimed at promotion, surveillance and CVH care in the Brazilian adult population.

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Saúde cardiovascular e validação do escore autorreferido no Brasil: uma análise da Pesquisa Nacional de Saúde

Cited by 9 publications

References 26 publications

Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms

Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms

Person-centered and measured life’s simple 7 cardiovascular health concordance and association with incident cardiovascular disease

Prevalence of ideal cardiovascular health in the Brazilian adult population - National Health Survey 2019

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