Low Prevalence of “Ideal Cardiovascular Health” in a Community-Based Population

Abstract

Background-Cardiovascular health is a new construct defined by the American Heart Association (AHA) as part of its 2020 Impact Goal definition. The applicability of this construct to community-based populations and the distributions of its components by race and sex have not been reported. Methods and Results-The AHA construct of cardiovascular health and the AHA ideal health behaviors index and ideal health factors index were evaluated among 1933 participants (mean age 59 years; 44% blacks; 66% women) in the community-based Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study. One of 1933 participants (0.1%) met all 7 components of the AHA's definition of ideal cardiovascular health. Less than 10% of participants met Ն5 components of ideal cardiovascular health in all subgroups (by race, sex, age, and income level). Thirty-nine subjects (2.0%) had all 4 components of the ideal health behaviors index and 27 (1.4%) had all 3 components of the ideal health factors index. Blacks had significantly fewer ideal cardiovascular health components than whites (2.0Ϯ1.2 versus 2.6Ϯ1.4; PϽ0.001). After adjustment by sex, age, and income level, blacks had 82% lower odds of having Ն5 components of ideal cardiovascular health (odds ratio 0.18, 95% confidence interval, 0.10 to 0.34; PϽ0.001). No interaction was found between race and sex. Conclusion-The prevalence of ideal cardiovascular health is extremely low in a middle-aged community-based study population. Comprehensive individual and population-based interventions must be developed to support the attainment of the AHAЈs 2020 Impact Goal for cardiovascular health. (Circulation. 2011;123:850-857.)

“Life's Simple 7” and Long‐Term Mortality After Stroke

“…Our findings of poor performance on cardiovascular health metrics are similar to several studies in different populations, including Northern Manhattan; Forsyth County, North Carolina; Jackson, Mississippi; Washington County, Maryland; Minneapolis, Minnesota; and Allegheny County, Pennsylvania 9, 10, 11, 12. Recent analyses have similarly demonstrated marked reductions in mortality5, 13, 14, 19 and 20‐year fatal and nonfatal CVD event rates10 with higher cardiovascular health scores.…”

“…Less than 2% of the US population meets all 7 cardiovascular health metrics 9, 10, 11, 12. Published studies of populations generally free of a history of symptomatic cardiovascular events show that individuals who meet a higher number of Life's Simple 7 health metrics tend to have lower cardiovascular and all‐cause mortality13, 14; however, the impact of meeting these health metrics on long‐term survival after a stroke is unknown.…”

The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study

“…Three quarters of participants met only 1 or 2 ideal CVH metrics goals. Previous studies have reported lower prevalence values especially for persons with 1 or 2 ideal CVH metrics 7, 25, 26, 27. Folsom et al, using data from the ARIC study,9 reported that around 54% of black men and 55% of black women had between 1 and 2 ideal CVH metrics.…”

“…Fewer Americans, particularly blacks, achieve ideal CVH, especially for BMI, physical activity, and healthy diet, which have been strongly associated with incident diabetes mellitus 7, 8, 9. The association between AHA‐defined ideal CVH and the development of diabetes mellitus is less clear among blacks than among other race‐ethnic groups.…”

Achieving and Maintaining Cardiovascular Health Across the Lifespan

“…Although studies have convincingly demonstrated the health benefits of the ideal CVH construct, prevalence of ideal CVH metrics has consistently been low in community samples [17], longitudinal cohort studies [10,18], and nationally representative surveys [11•, 12, 19]. Longitudinal analyses of multiple NHANES surveys demonstrated prevalence of ideal CVH of less than 2 % that remained similarly low over time [11•].…”