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

Abstract

Background In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH. Methods A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I2 statistics. Results This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics. Conclusions To the best of our knowledge, this is the first systematic review on the relationship between participants’ socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.

Changes in ideal cardiovascular health among Malawian adults from 2009 to 2017

“…Even modest improvements in the CVH status could lead to prolonged years of life free from CVD 6 . These gains have been observed in young adults, middle-aged, and elderly populations 11 . The prevalence and distribution of CVH has been widely studied in different populations.…”

“…Poor CVH (0–1 ideal metrics) was more common than ideal CVH (6–7 ideal metrics) in most countries, whilst intermediate CVH (2–5 ideal metrics) was the most prevalent 12 . These studies found smoking to be the best CVH metric (71%) and healthy diet the worst (5.8%) 11 , 12 .…”

“…The prevalence and distribution of CVH has been widely studied in different populations. Between 2010 and 2020, pooled estimates show a low global prevalence of ideal CVH, that is, between 3.3% (6–7 ideal CVH metrics) and 16% (5–7 ideal CVH metrics) in the adult population 5 , 11 . Poor CVH (0–1 ideal metrics) was more common than ideal CVH (6–7 ideal metrics) in most countries, whilst intermediate CVH (2–5 ideal metrics) was the most prevalent 12 .…”

Efectos del tratamiento de fuerza y flexibilidad para la anteposición de cabeza y cuello en adultos mayores sobre la capacidad aeróbica submáxima según nivel socioeconómico (Effects of strength and flexibility treatment for forward head posture positioning in older adults on submaximal aerobic capacity according to socioeconomic level)

“…Se suma a estos indicadores, mayores tasas de hogares monoparentales sin padres, bajas tasas de educación superior, y bajas tasas de dueños de una vivienda (Jankovic, Mandic-Rajcevic, Davidovic, & Jankovic, 2021;Townsend, Chen, & Wuthrich, 2021).…”

“…Se asoció incluso con un riesgo de mortalidad de un 24 % más alto después de una fractura de cadera en comparación con un individuo de alto nivel socioeconómico. Se asocia a menor densidad ósea, vejez,, índice de masa corporal bajo, exceso de alcohol, tabaquismo, artritis reumatoide, fracturas previas, uso de glucocorticoides, inactividad física (Jankovic et al, 2021;Valentin et al, 2020).…”