Ideal cardiovascular health metrics and risk of cardiovascular disease or mortality: A meta-analysis

Individuals with favorable levels of all readily measured major CVD risk factors (low CV risk) during middle age incur lower cardiovascular morbidity and mortality, lower all-cause mortality, and lower Medicare costs at older ages compared to adults with one or more unfavorable CVD risk factors. Studies on predictors of low CV risk in Hispanics/Latinos have focused solely on Mexican-Americans. The objective of this study was to use data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; enrolled 2008 to 2011) to assess relationships of nativity and length of residence in the US, a commonly used proxy for acculturation, with low CV risk (not currently smoking; no diabetes; untreated total cholesterol <200mg/dL; untreated blood pressure <120/<80; body mass index <25 kg/m2; and no major ECG abnormalities) in 15,047 Central American, South American, Cuban, Dominican, Mexican, Puerto Rican men and women, and Hispanic/Latino men and women identifying as other or >1 heritage. We also tested whether associations varied by Hispanic/Latino background. Women living in the US<10 years were 1.96 (95% confidence interval: 1.37, 2.80) times more likely to be low CV risk than US-born women after adjusting for sociodemographic characteristics, diet, physical activity, and self-reported experiences of ethnic discrimination. Findings varied in men by Hispanic/Latino background, but length of residence was largely unrelated to low CV risk. These findings highlight the role acculturative processes play in shaping cardiovascular health in Hispanics/Latinos.

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“…5 These cutpoints were chosen to be consistent with the American Heart Association’s criteria for ideal cardiovascular health. 17–19 …”

Section: Methodsmentioning

confidence: 99%

Relationships of nativity and length of residence in the U.S. with favorable cardiovascular health among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Kershaw

Giacinto

Gonzalez

et al. 2016

Preventive Medicine

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“…Recent data have indicated that the presence of more ideal CVH metrics is inversely associated with the incidence of CVD, stroke, and mortality . According to a previous meta‐analysis, the aggregated risk estimate derived from 4 studies suggested 75% and 45% markedly lower risks for CV and all‐cause mortality, respectively. Although this meta‐analysis was strongly heterogeneous, it did not further examine the sources of this heterogeneity, such as subgroup analysis and a graph of dose–response relationship.…”

Section: Introductionmentioning

confidence: 99%

Association between ideal cardiovascular health metrics and risk of cardiovascular events or mortality: A meta‐analysis of prospective studies

Guo

Zhang

2017

Clinical Cardiology

108

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Background Observational studies evaluating the relationship between ideal cardiovascular health (CVH) metrics and risk of cardiovascular (CV) events and mortality yielded inconsistent results. Hypothesis Improvement in CVH metrics can result in substantial reductions in the risk of cardiovascular disease (CVD), stroke, and mortality. Methods We examined associations between ideal CVH metrics and CV events and mortality by conducting a meta‐analysis of data from prospective cohort studies identified by searching PubMed and Web of Science from their inception to February 2017 and reviewing the reference lists of the retrieved articles. Results Thirteen prospective studies involving a total of 193 126 cohort members were included in this meta‐analysis. When comparing the most to the least category of ideal CVH metrics, the overall relative risks (RRs) were 0.54 (95% confidence interval [CI]: 0.41‐0.69) for all‐cause mortality, 0.30 (95% CI: 0.18‐0.51) for CV mortality, 0.22 (95% CI: 0.11‐0.42) for CVD, and 0.33 (95% CI: 0.20‐0.55) for stroke, respectively. A linear dose–response relationship was seen in all‐cause and CV mortality. The risk decreased by 11% and 19% for each increase in ideal CVH metrics. For the analyses of ideal health status in relation to all‐cause and CV mortality, significant results were obtained from smoking, diet, physical activity, plasma glucose levels, and blood pressure. Conclusions Ideal CVH status, or even 1 point increase in CVH metrics, can result in substantial reductions in the risk of CVD, stroke, and mortality. Improving metrics of smoking, diet, physical activity, plasma glucose levels, and blood pressure will achieve the highest benefits.

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“…The value of deep phenotyping has been demonstrated in studies of common CVDs (6). A natural extension of such studies has been to embrace principles of more precise clinical phenotyping in cardio-oncology.…”

Section: Panomics: Biomarker Identificationmentioning

confidence: 99%

Precision Cardio-Oncology

et al. 2019

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Modern oncologic therapies and care have resulted in a growing population of cancer survivors with comorbid, chronic health conditions. As an example, many survivors have an increased risk of cardiovascular complications secondary to cardiotoxic systemic and radiation therapies. In response, the field of cardio-oncology has emerged as an integral component of oncologic patient care, committed to the early diagnosis and treatment of adverse cardiac events. However, as current clinical management of cancer therapyrelated cardiovascular disease remains limited by a lack of phenotypic data, implementation of precision medicine approaches has become a focal point for deep phenotyping strategies. In particular, -omics approaches (a field of study in biology ending in -omic, such as genomics, proteomics, or metabolomics) have shown enormous potential in identifying sensitive biomarkers of cardiovascular disease, applying sophisticated, pattern-revealing technologies to growing databases of biologic molecules. Moreover, the use of -omics to inform radiologic strategies may add a dimension to future clinical practices. In this review, we present a paradigm for a precision medicine approach to the care of cardiotoxin-exposed cancer patients. We discuss the role of current imaging techniques; demonstrate how -omics can advance our understanding of disease phenotypes; and describe how molecular imaging can be integrated to personalize surveillance and therapeutics, ultimately reducing cardiovascular morbidity and mortality in cancer patients and survivors.

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Ideal cardiovascular health metrics and risk of cardiovascular disease or mortality: A meta-analysis

Cited by 152 publications

References 31 publications

Relationships of nativity and length of residence in the U.S. with favorable cardiovascular health among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Relationships of nativity and length of residence in the U.S. with favorable cardiovascular health among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Association between ideal cardiovascular health metrics and risk of cardiovascular events or mortality: A meta‐analysis of prospective studies

Precision Cardio-Oncology

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