Ideal cardiovascular health and incident hypertension

Abstract

Ideal cardiovascular health (CVH) has been defined by the American Heart Association as the absence of disease and presence of 7 key health factors. Since it is unknown whether cumulative exposure to CVH reduces the risk of developing arterial hypertension, we prospectively examined the potential association between cumulative CVH (cumCVH) score (except for blood pressure metrics) and incident hypertension.Of the 101,510 participants with an age range of 18 to 98 years in this longitudinal community-based Kailuan study, our cohort included those 15,014 participants without hypertension at baseline and who had follow-up examinations 2, 4, and 6 years later. CumCVH was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (points × year). Based on the cumCVH score, the study population was stratified into groups of <44 points, 44 to 48 points, 49 to 54 points, 55 to 59 points, and ≥60 points.Incidence of hypertension ranged from 16.76% in the lowest cumCVH category to 11.52% in the highest cumCVH category. After adjusting for age, sex, education level, income level, high-sensitivity C-reactive protein concentration, uric acid concentration, resting heart rate, parental history of hypertension at baseline, and medication usage before the third follow-up examination, participants in the highest cumCVH category had a significantly reduced risk of incident hypertension compared with those in the lowest cumCVH category (adjusted odds ratio 0.60, 95% confidence interval 0.50–0.71). For every increase in category based on the cumCVH score, the risk of hypertension decreased by approximately 2% (odds ratio 0.98, 95% confidence interval 0.97–0.98). The effect was consistent across sex and age groups.A higher cumCVH score is associated with a lower risk of incident hypertension.

Relationship between the exposure to cumulative cardiovascular health behaviors and factors and chronic kidney disease—The Kailuan study

“…The 101,510 participants were recruited between June 2006 and October 2007 and were followed every 2 years for three follow-ups (2008–2009, 2010–2011, and 2012–2013) [22]. …”

“…The Framingham Heart Study [ 18 ] showed that the assessment of the duration and grade of the CVH metrics as measure for the cumulative exposure was more accurate than a cross-sectional analysis in examining the relationship between the CVH metrics and diseases. Meantime, higher CVH cumulative exposure is protective against atherosclerosis, diabetes mellitus, and hypertension [ 19 – 22 ]. Zemaitis et al [ 23 ] showed that among patients with atherosclerosis, higher blood pressure cumulative exposure does harm the kidneys.…”

Cardiovascular risk factors and electrocardiographic anomalies in university students from Itá, Paraguay

“…La presencia de estilos de vida saludables en los jóvenes se asocia significativamente a la reducción de hipertensión arterial en la edad adulta y sus consecuencias (1,3). De ahí la importancia de promocionar hábitos de vida saludables en ellos y detectar estas enfermedades para realizar tratamiento oportuno.…”

“…Las enfermedades cardiovasculares son la principal causa de mortalidad en el mundo y 80% de ellas ocurren en países en vías de desarrollo, predominando actualmente en sujetos cada vez más jóvenes (1,2). La Sociedad Americana de Cardiología definió en 2010 a la salud cardiovascular ideal como aquella que presenta simultáneamente tres factores fisiológicos (colesterol total, presión arterial y glucemia en niveles óptimos) y cuatro hábitos saludables (no fumar, índice de masa corporal normal, adecuada actividad física y dieta sana) (3). Los adolescentes y adultos jóvenes que mantengan estos factores llegarán a la edad adulta sin hipertensión arterial, diabetes mellitus, dislipidemias ni calcificaciones coronarias (4,5).…”

“…La hipertensión arterial en los adolescentes y adultos está aumentando globalmente y se ha duplicado en el último decenio (16)(17)(18). Este incremento está relacionado a estilos de vida poco saludables como la ingesta exagerada de sal, sedentarismo, obesidad (2,3,16,18). Se espera un incremento de las complicaciones relacionadas a la hipertensión arterial: accidentes cerebrovasculares, cardiopatías y nefropatía crónica.…”