Prevalence and changes over time of ideal cardiovascular health metrics among African–Americans: The Jackson Heart Study

Abstract

Objectives To assess the prevalence and changes over time of ideal Life’s Simple Seven (LSS) in African-Americans. Methods Prospective cohort of 5301 African-Americans from the Jackson Heart Study (JHS) from 2000 to 2013. Each of the LSS metrics was categorized as poor, intermediate, or ideal. Results Among men, the prevalence of having 0, 1, 2, 3, 4, 5, 6, and 7 ideal LSS was 3.3%, 23.0%, 33.5%, 24.7%, 11.6%, 3.6%, 0.3%, and 0%, respectively. Corresponding values for women were 1.7%, 26.3%, 33.1%, 22.8%, 11.9%, 3.7%, 0.6%, and 0%. Prevalence of ideal diet was 0.9%. The proportions of those meeting LSS ideal recommendations for cholesterol and fasting glucose declined from the first through third JHS visits across all age groups, whereas prevalence of ideal BMI declined only in participants <40 years at a given visit. Prevalence of ideal blood pressure did not change over time and being ideal on physical activity improved from the first [18.3% (95% CI: 17.3% to 19.3%)] to third visit [24.8% (95% CI: 23.3% to 26.3%)]. Conclusions Our data show a low prevalence of ideal LSS (especially diet, physical activity, and obesity) in the JHS and a slight improvement in adherence to physical activity recommendations over time.

Low levels of ideal cardiovascular health in a semi-urban population of Western Nepal: a population-based, cross-sectional study

“…This is comparable with a number of studies from the USA,26 China27 and Korea28 reporting less than 1% of study participants had ideal cardiovascular health. A community-based study of 1933 individuals from USA revealed that only one participant (0.1%) met all ideal cardiovascular health metrics and less than 10% of the participants met five metrics in all subgroups 29.…”

Ideal Cardiovascular Health, Cardiovascular Remodeling, and Heart Failure in Blacks

“…We constructed the Simple 7 score for each JHS participant by assigning a score of “1” (ideal status) or “0” (non-ideal) for each of the Simple 7 metrics (Supplemental Table 1) as previously published 4, 10 . For consistency with prior reports 4 , we used metrics already adjudicated within the Jackson Heart Study (as opposed to ideal, intermediate, and poor categories as defined in other work 4 ).…”

“…A prime contributor to this racial disparity is a higher prevalence and earlier onset of cardiometabolic disease, including obesity, hypertension, diabetes, and physical inactivity 3 . Though professional guidelines reinforcing ideal cardiovascular health target improvements in cardiometabolic health to prevent disease (“Life’s Simple 7”), recent data in over 5,000 African-Americans from the Jackson Heart Study (JHS) indicate a low prevalence of ideal cardiovascular health characteristics (specifically diet, body mass index, and physical activity) with only modest improvements over time 4 . In largely non-African American populations, achievement of fewer Life’s Simple 7 components is associated with more adverse left ventricular (LV) remodeling 5 and greater cardiovascular and non-cardiovascular disease (CVD) mortality 6, 7 .…”

“…Given prior results in JHS documenting a low prevalence of physical activity, greater body mass index (BMI), and poor diet 4 , we hypothesized that achievement of fewer ideal components of Life’s Simple 7 would be associated with greater risk of incident HF and more adverse cardiovascular remodeling by CMR.…”

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

“…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.…”