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

BACKGROUND: The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. METHODS AND RESULTS: Our sample included 2668 adults in the Jackson Heart Study...

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Autores principales: Effoe, Valery S., Carnethon, Mercedes R., Echouffo‐Tcheugui, Justin B., Chen, Haiying, Joseph, Joshua J., Norwood, Arnita F., Bertoni, Alain G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669153/
https://www.ncbi.nlm.nih.gov/pubmed/28637777
http://dx.doi.org/10.1161/JAHA.116.005008
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author Effoe, Valery S.
Carnethon, Mercedes R.
Echouffo‐Tcheugui, Justin B.
Chen, Haiying
Joseph, Joshua J.
Norwood, Arnita F.
Bertoni, Alain G.
author_facet Effoe, Valery S.
Carnethon, Mercedes R.
Echouffo‐Tcheugui, Justin B.
Chen, Haiying
Joseph, Joshua J.
Norwood, Arnita F.
Bertoni, Alain G.
author_sort Effoe, Valery S.
collection PubMed
description BACKGROUND: The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. METHODS AND RESULTS: Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person‐years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high‐sensitivity C‐reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74–0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79–1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. CONCLUSIONS: The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance.
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spelling pubmed-56691532017-11-09 The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study Effoe, Valery S. Carnethon, Mercedes R. Echouffo‐Tcheugui, Justin B. Chen, Haiying Joseph, Joshua J. Norwood, Arnita F. Bertoni, Alain G. J Am Heart Assoc Original Research BACKGROUND: The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. METHODS AND RESULTS: Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person‐years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high‐sensitivity C‐reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74–0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79–1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. CONCLUSIONS: The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance. John Wiley and Sons Inc. 2017-06-21 /pmc/articles/PMC5669153/ /pubmed/28637777 http://dx.doi.org/10.1161/JAHA.116.005008 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Effoe, Valery S.
Carnethon, Mercedes R.
Echouffo‐Tcheugui, Justin B.
Chen, Haiying
Joseph, Joshua J.
Norwood, Arnita F.
Bertoni, Alain G.
The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study
title The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study
title_full The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study
title_fullStr The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study
title_full_unstemmed The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study
title_short The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study
title_sort american heart association ideal cardiovascular health and incident type 2 diabetes mellitus among blacks: the jackson heart study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669153/
https://www.ncbi.nlm.nih.gov/pubmed/28637777
http://dx.doi.org/10.1161/JAHA.116.005008
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