Association between ideal cardiovascular health and risk of sudden cardiac death and all-cause mortality among middle-aged men in Finland

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> Strong associations have been demonstrated between the American Heart Association’s cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland. </jats:p></jats:sec><jats:sec><jats:title>Methods and results</jats:title><jats:p> We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0–2 (poor), 3–4 (intermediate) and 5–7 (ideal). Multivariate Cox regression models were used to estimate the hazards ratios (HRs) and 95% confidence intervals (CIs) of ideal CVH metrics for SCD and all-cause mortality. During a median follow-up period of 25.8 years, 280 SCDs and 1289 all-cause mortality events were recorded. The risks of SCD and all-cause mortality decreased continuously with increasing number of CVH metrics across the range 2–7 ( p value for non-linearity for all &lt;0.05). In multivariable analyses, men with an ideal CVH score had an 85% reduced risk of SCD compared with men with a poor CVH score (HR 0.15; 95% CI 0.05–0.48; p = 0.001). For all-cause mortality, there was a 67% lower risk among men with an ideal CVH score compared with those with a poor CVH score (HR 0.33; 95% CI 0.23–0.49; p &lt;0.001). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Ideal CVH metrics were strongly and linearly associated with decreased risks of SCD and all-cause mortality among middle-aged men in Finland. </jats:p></jats:sec>

Demographic and socioeconomic inequalities in ideal cardiovascular health: A systematic review and meta-analysis

“…Sаmple sizes ranged from 616 to 1,012,418. Two studies [ 47 , 51 ] included only males. Participants, were adults 18 years and older with an age range from 18 to 107 years.…”

Changes in Cardiovascular Health Status and Risk of Sudden Cardiac Death in Older Adults

“…Another recent study conducted in Finland showed that baseline CVH status was strongly and linearly associated with the future risk of SCD and all-cause death. 10 In that study, ideal physical activity did not show an independent association with the risk of SCD, compared to poor physical activity, because the study included participants with high physical activity, which itself might be a cause of sudden death. 29 However, in our study, ideal physical activity, which included vigorous activity, was related to lower risks of both SCD and all-cause death.…”

“… 6 7 8 9 In a recent study conducted in Finland, a high CVH score at baseline substantially reduced the risk of SCD among middle-aged men. 10 Although several studies have assessed the incidence of SCD, 11 limited data are available regarding the predictors of SCD in older adults. 12 13 14 The effects of changes in CVH status, in particular, over time on SCD in older adults have not been widely studied.…”

Editorial: Ideal cardiovascular health and sudden cardiac death

“…The risk of SCD and all-cause mortality decreased continuously with increasing score of CVH metrics across the range 2-7. 8 This study emphasizes that ideal CVH metrics are strongly inversely associated with the risk of SCD and all-cause mortality. Early intervention for ideal CVH is anticipated to further reduce the residual risk of SCD.…”