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Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study

BACKGROUND: We hypothesized that the American Heart Association's metric of ideal cardiovascular health (CVH) predicts improved long‐term functional status after adjusting for incident stroke and myocardial infarction. METHODS AND RESULTS: In the prospective, multiethnic Northern Manhattan Stud...

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Autores principales: Dhamoon, Mandip S., Dong, Chuanhui, Elkind, Mitchell S. V., Sacco, Ralph L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345864/
https://www.ncbi.nlm.nih.gov/pubmed/25677566
http://dx.doi.org/10.1161/JAHA.114.001322
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author Dhamoon, Mandip S.
Dong, Chuanhui
Elkind, Mitchell S. V.
Sacco, Ralph L.
author_facet Dhamoon, Mandip S.
Dong, Chuanhui
Elkind, Mitchell S. V.
Sacco, Ralph L.
author_sort Dhamoon, Mandip S.
collection PubMed
description BACKGROUND: We hypothesized that the American Heart Association's metric of ideal cardiovascular health (CVH) predicts improved long‐term functional status after adjusting for incident stroke and myocardial infarction. METHODS AND RESULTS: In the prospective, multiethnic Northern Manhattan Study, stroke‐free individuals in northern Manhattan aged ≥40 years had annual assessments of the primary outcome of functional status with the Barthel index (BI), for a median of 13 years. Ideal CVH was calculated as a composite of 7 measures, each scored on a scale of 0 to 2. Primary predictors were (1) number of ideal CVH metrics, and (2) total score of all CVH metrics. Of 3219 participants, mean age was 69 years (SD 10), 63% were female, 21% were white, 25% were non‐Hispanic black, and 54% were Hispanic. Twenty percent had 0 to 1 ideal CVH metrics, 32% had 2, 30% had 3, 14% had 4, and 4% had 5 to 7. Both number of ideal CVH categories and higher CVH metric scores were associated with higher mean BI scores at 5 and 10 years. 0047 Gradients persisted when results were adjusted for incident stroke and myocardial infarction, when mobility and nonmobility domains of the BI were analyzed separately, and when BI was analyzed dichotomously. At 10 years, in a fully adjusted model, differences in mean BI score were lower for poor versus ideal physical activity (3.48 points, P<0.0001) and fasting glucose (4.58 points, P<0.0001). CONCLUSIONS: Ideal CVH predicts functional status, even after accounting for incident vascular events. Vascular functional impairment is an important outcome that can be reduced by optimizing vascular health.
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spelling pubmed-43458642015-03-10 Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study Dhamoon, Mandip S. Dong, Chuanhui Elkind, Mitchell S. V. Sacco, Ralph L. J Am Heart Assoc Original Research BACKGROUND: We hypothesized that the American Heart Association's metric of ideal cardiovascular health (CVH) predicts improved long‐term functional status after adjusting for incident stroke and myocardial infarction. METHODS AND RESULTS: In the prospective, multiethnic Northern Manhattan Study, stroke‐free individuals in northern Manhattan aged ≥40 years had annual assessments of the primary outcome of functional status with the Barthel index (BI), for a median of 13 years. Ideal CVH was calculated as a composite of 7 measures, each scored on a scale of 0 to 2. Primary predictors were (1) number of ideal CVH metrics, and (2) total score of all CVH metrics. Of 3219 participants, mean age was 69 years (SD 10), 63% were female, 21% were white, 25% were non‐Hispanic black, and 54% were Hispanic. Twenty percent had 0 to 1 ideal CVH metrics, 32% had 2, 30% had 3, 14% had 4, and 4% had 5 to 7. Both number of ideal CVH categories and higher CVH metric scores were associated with higher mean BI scores at 5 and 10 years. 0047 Gradients persisted when results were adjusted for incident stroke and myocardial infarction, when mobility and nonmobility domains of the BI were analyzed separately, and when BI was analyzed dichotomously. At 10 years, in a fully adjusted model, differences in mean BI score were lower for poor versus ideal physical activity (3.48 points, P<0.0001) and fasting glucose (4.58 points, P<0.0001). CONCLUSIONS: Ideal CVH predicts functional status, even after accounting for incident vascular events. Vascular functional impairment is an important outcome that can be reduced by optimizing vascular health. Blackwell Publishing Ltd 2015-02-12 /pmc/articles/PMC4345864/ /pubmed/25677566 http://dx.doi.org/10.1161/JAHA.114.001322 Text en © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Dhamoon, Mandip S.
Dong, Chuanhui
Elkind, Mitchell S. V.
Sacco, Ralph L.
Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
title Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
title_full Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
title_fullStr Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
title_full_unstemmed Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
title_short Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
title_sort ideal cardiovascular health predicts functional status independently of vascular events: the northern manhattan study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345864/
https://www.ncbi.nlm.nih.gov/pubmed/25677566
http://dx.doi.org/10.1161/JAHA.114.001322
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