Association of Cardiovascular Health Score Trajectory With Incident Myocardial Infarction in Hypertensive Patients

Huang, Zegui; Chen, Zekai; Wang, Xianxuan; Ding, Xiong; Cai, Zefeng; Li, Weijian; Cai, Zhiwei; Lan, Yulong; Fang, Wei; Wang, Anxin; Chen, Youren

doi:10.1161/hypertensionaha.122.19633

Cited by 11 publications

(5 citation statements)

References 41 publications

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“…Although no direct parallels exist, the trajectory of cardiovascular health scores has been widely studied since the American Heart Association proposed the 7 cardiovascular health metrics. Various studies have demonstrated the efficacy of cardiovascular health trajectories in predicting CVD development [ 15 , 26 , 27 ], indirectly supporting our perspective.…”

Section: Discussionsupporting

confidence: 80%

Multi-trajectories of triglyceride-glucose index and lifestyle with Cardiovascular Disease: a cohort study

Zhou,

Ding,

Lan

et al. 2023

Cardiovasc Diabetol

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Background Previous studies using trajectory models focused on examining the longitudinal changes in triglyceride-glucose (TyG) levels and lifestyle scores separately, without exploring the joint evolution of these two factors. This study aimed to identify the multi-trajectories of TyG levels and lifestyle scores and assess their association with the risk of cardiovascular disease (CVD). Methods The study enrolled 47,384 participants from three health surveys of the Kailuan Study. The TyG index was computed as Ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2], and the lifestyle scores were derived from five factors, including smoking, alcohol consumption, physical activity, sedentary behaviors, and salt intake. A group-based multi-trajectory model was adopted to identify multi-trajectories of TyG levels and lifestyle scores. The association of identified multi-trajectories with incident CVD was examined using Cox proportional hazard model. Results Five distinct multi-trajectories of TyG levels and lifestyle scores were identified. During a median follow-up period of 10.98 years, 3042 participants developed CVD events (2481 strokes, 616 myocardial infarctions, and 55 co-current stroke and myocardial infarctions). In comparison to group 3 with the lowest TyG levels and the best lifestyle scores, the highest CVD risk was observed in group 5 characterized by the highest TyG levels and moderate lifestyle scores (HR = 1.76, 95% CI: 1.50–2.05). Group 2 with higher TyG levels and the poorest lifestyle scores had a 1.45-fold (95% CI 1.26–1.66) risk of CVD, and group 1 with lower TyG levels and poorer lifestyle scores had a 1.33-fold (95% CI 1.17–1.50) risk of CVD. Group 4, with moderate TyG levels and better lifestyle scores, exhibited the lowest CVD risk (HR = 1.32, 95% CI: 1.18–1.47). Conclusions Distinct multi-trajectories of TyG levels and lifestyle scores corresponded to differing CVD risks. The CVD risk caused by a high level TyG trajectory remained increased despite adopting healthier lifestyles. These findings underscored the significance of evaluating the combined TyG and lifestyle patterns longitudinally, and implementing early interventions to reduce CVD risk by lowering TyG levels.

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Section: Discussionsupporting

confidence: 80%

Multi-trajectories of triglyceride-glucose index and lifestyle with Cardiovascular Disease: a cohort study

Zhou,

Ding,

Lan

et al. 2023

Cardiovasc Diabetol

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“…Prior studies evaluating the trends of CVH over 20 years (5 CVH trajectories: low-stable, moderate-decreasing, moderate-increasing, high-stable I, and high-stable II) indicated that improvement or attainment of better CVH metrics through midlife to late life was associated with a lower CVD prevalence and better cardiovascular structure and function [ 33 , 34 ]. Recently, a study during a follow-up of 10 years showed that high-stable groups could be decreased 64–76% risk of MI in reference to the low-stable group [ 18 ]. Similarly, studies also demonstrated that the elevated-stable group could reduce the risk of arterial stiffness (HR: 0.23; 95% CI 0.18–0.29) [ 35 ], whereas the declining CVH status group was associated with a higher risk of carotid intima-media thickness (HR: 2.40; 95% CI 1.30–4.50) [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, studies examined the association between CVH score trajectories or CVH metrics change over time and CVDs or mortality during follow-up [ 15 – 17 ]. Previous studies indicated that participants with the high-stable II trajectory of CVH score had 76–79% decreased risk of CVDs and mortality compared with the low-stable group [ 16 , 18 ]. These findings suggest the importance of maintaining a higher CVH score or ideal CVH metrics for preventing CVDs.…”

Section: Introductionmentioning

confidence: 99%

Time spent in a better cardiovascular health and risk of cardiovascular diseases and mortality: a prospective cohort study

et al. 2023

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Background The protective effect of a higher ideal cardiovascular health (CVH) score on cardiovascular diseases (CVDs) and mortality is well recognized. However, little is known regarding the length of favorable CVH status associated with CVDs and mortality. This study aimed to examined whether the duration of better (ideal or intermediate) CVH is associated with risk of developing CVDs and mortality. Methods This prospective cohort study used data from 83,536 individuals from 2006 to 2020 who were enrolled in the Kailuan Study. The CVH scores of individuals were assessed at visits 1, 2, 3, and 4, respectively. The years spent in better CVH were estimated for each individual as the number of examination cycles (0–4) in which the participant was in that CVH score ≥ 8 multiplied by 2 (the mean year interval of each visit). The primary outcomes are CVD events and all-cause mortality. Results After a median follow-up period of 7.48 years, 5486 (7.07%) cases of incident CVD events and 7669 (9.18%) deaths occurred. Compared with participants in “ ≤ 4 years” group, those who maintained for > 4 years had less likely to develop adverse outcomes (CVD events: hazard ratio (HR): 0.60, 95% confidence interval (CI 0.56–0.63; all-cause mortality: HR: 0.77, 95% CI 0.74–0.81). The number of years spent in better CVH was nonlinearly correlated with CVD events or mortality (all Ps for nonlinear < 0.05). The results indicated that maintaining more than 6 years in a better CVH status was associated with a decreased risk of CVD events or mortality. Conclusion Our study indicates that individuals maintaining more than 6 years in better CVH could increase cardiometabolic benefits and a lower risk of all-cause mortality.

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“…The Kailuan study is a large community-based prospective cohort study that is being conducted in Tangshan, China and aims to identify the risk factors for chronic non-communicable diseases. The research design and methods of the Kailuan study have been described previously [ 17 , 18 ]. In brief, the Kailuan study started in 2006–2007, a total of 101,510 participants were recruited for the baseline survey, and they were followed up every 2 years.…”

Section: Methodsmentioning

confidence: 99%

Relationship between cumulative exposure to triglyceride-glucose index and heart failure: a prospective cohort study

Zheng,

Chen,

et al. 2023

Cardiovasc Diabetol

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Background High triglyceride-glucose index (TyG) is a major risk factor for heart failure, but the long-term effect of high TyG index on the risk of developing heart failure remains unclear. Therefore, we aimed to determine the relationship between the cumulative exposure to TyG index and the risk of heart failure. Methods A total of 56,149 participants from the Kailuan Study, who participated in three consecutive health examinations in 2006, 2008, and 2010 and had no history of heart failure or cancer were recruited for this study. The cumulative TyG index was calculated as the weighted sum (value × time) of the mean TyG index for each time interval. The participants were placed into quartiles based on their cumulative TyG index. The study ended on December 31, 2020, and the primary outcome was new-onset heart failure during the follow-up period. In addition, a Cox proportional hazards regression model and a restricted cubic spline analysis were used to further evaluate the relationship between cumulative TyG index and the risk of heart failure. Results During a median follow-up period of 10.04 years, a total of 1,312 new heart failure events occurred. After adjustment for potential confounding factors, the Cox regression analysis showed that the hazard ratios (95% confidence intervals) for the risk of heart failure in the Q2, Q3, and Q4 groups were 1.02 (0.83,1.25), 1.29 (1.07,1.56) and 1.40 (1.15,1.71), respectively, vs. the Q1 group. The subgroup analysis showed a significant interaction between cumulative TyG index and BMI or waist circumference, but there was no interaction between age, sex and cumulative TyG index. The restricted cubic spline analysis showed a dose-response relationship between cumulative TyG index and the risk of heart failure. In addition, the sensitivity analysis generated results that were consistent with the primary results. Conclusions High cumulative TyG index is associated with a higher risk of heart failure. Thus, the TyG index may be useful for the identification of individuals at high risk of heart failure. The present findings emphasize the importance of the long-term monitoring of the TyG index in clinical practice.

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Association of Cardiovascular Health Score Trajectory With Incident Myocardial Infarction in Hypertensive Patients

Cited by 11 publications

References 41 publications

Multi-trajectories of triglyceride-glucose index and lifestyle with Cardiovascular Disease: a cohort study

Multi-trajectories of triglyceride-glucose index and lifestyle with Cardiovascular Disease: a cohort study

Time spent in a better cardiovascular health and risk of cardiovascular diseases and mortality: a prospective cohort study

Relationship between cumulative exposure to triglyceride-glucose index and heart failure: a prospective cohort study

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