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Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort

BACKGROUND: The American Heart Association recommends Life’s Simple 7 as ideal cardiovascular health (ICVH) to reduce cardiovascular risk. Rate advancement period (RAP), a useful tool to quantify and communicate exposure impact on risks, may enhance communication about the benefits of achieving ICVH...

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Autores principales: Fernandez-Lazaro, Cesar I., Sayon-Orea, Carmen, Toledo, Estefania, Moreno-Iribas, Conchi, Guembe, María J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254604/
https://www.ncbi.nlm.nih.gov/pubmed/35787272
http://dx.doi.org/10.1186/s12916-022-02417-x
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author Fernandez-Lazaro, Cesar I.
Sayon-Orea, Carmen
Toledo, Estefania
Moreno-Iribas, Conchi
Guembe, María J.
author_facet Fernandez-Lazaro, Cesar I.
Sayon-Orea, Carmen
Toledo, Estefania
Moreno-Iribas, Conchi
Guembe, María J.
author_sort Fernandez-Lazaro, Cesar I.
collection PubMed
description BACKGROUND: The American Heart Association recommends Life’s Simple 7 as ideal cardiovascular health (ICVH) to reduce cardiovascular risk. Rate advancement period (RAP), a useful tool to quantify and communicate exposure impact on risks, may enhance communication about the benefits of achieving ICVH. We aimed to examine whether greater adherence to ICVH metrics was associated with reduced incidence of cardiovascular risk in a population-based cohort and estimate its impact on the timing of occurrence using RAP. METHODS: Prospective analyses of 3826 participants, initially free from cardiovascular disease at baseline, enrolled in the Vascular Risk in Navarra Study (RIVANA), a Mediterranean population-based cohort of Spanish adults. ICVH metrics were defined using participants’ baseline information as follows: never-smoker or quitting > 12 months ago, body mass index < 25 kg/m(2), ≥ 150 min/week of moderate physical activity or equivalent, healthy dietary pattern (≥ 9 points on a validated 14-item Mediterranean diet adherence screener), untreated cholesterol < 200 mg/dL, untreated blood pressure < 120/80 mmHg, and untreated fasting blood glucose < 100 mg/dL. Participants were assigned 1 point for each achieved metric and were grouped according to their number of accumulated metrics in ≤ 2, 3, 4, and ≥ 5. The primary endpoint was major cardiovascular events (composite of myocardial infarction, stroke, or death from cardiovascular causes). Cox proportional hazard ratios (HRs) and RAPs with their corresponding 95% confidence intervals (95% CI) adjusted for potential confounders were calculated. RESULTS: During a median follow-up of 12.8 years (interquartile range 12.3–13.1), a total of 194 primary endpoints were identified. Compared to participants with ≤ 2 ideal metrics, HR (95% CI) for major cardiovascular events among participants meeting ≥ 5 metrics was 0.32 (0.17–0.60) with RAP (95% CI) of − 14.4 years (− 22.9, − 5.9). CONCLUSIONS: Greater adherence to ICVH metrics was associated with lower cardiovascular risk among Spanish adults of the RIVANA cohort. Adherence to ideal metrics may substantially delay cardiovascular risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02417-x.
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spelling pubmed-92546042022-07-06 Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort Fernandez-Lazaro, Cesar I. Sayon-Orea, Carmen Toledo, Estefania Moreno-Iribas, Conchi Guembe, María J. BMC Med Research Article BACKGROUND: The American Heart Association recommends Life’s Simple 7 as ideal cardiovascular health (ICVH) to reduce cardiovascular risk. Rate advancement period (RAP), a useful tool to quantify and communicate exposure impact on risks, may enhance communication about the benefits of achieving ICVH. We aimed to examine whether greater adherence to ICVH metrics was associated with reduced incidence of cardiovascular risk in a population-based cohort and estimate its impact on the timing of occurrence using RAP. METHODS: Prospective analyses of 3826 participants, initially free from cardiovascular disease at baseline, enrolled in the Vascular Risk in Navarra Study (RIVANA), a Mediterranean population-based cohort of Spanish adults. ICVH metrics were defined using participants’ baseline information as follows: never-smoker or quitting > 12 months ago, body mass index < 25 kg/m(2), ≥ 150 min/week of moderate physical activity or equivalent, healthy dietary pattern (≥ 9 points on a validated 14-item Mediterranean diet adherence screener), untreated cholesterol < 200 mg/dL, untreated blood pressure < 120/80 mmHg, and untreated fasting blood glucose < 100 mg/dL. Participants were assigned 1 point for each achieved metric and were grouped according to their number of accumulated metrics in ≤ 2, 3, 4, and ≥ 5. The primary endpoint was major cardiovascular events (composite of myocardial infarction, stroke, or death from cardiovascular causes). Cox proportional hazard ratios (HRs) and RAPs with their corresponding 95% confidence intervals (95% CI) adjusted for potential confounders were calculated. RESULTS: During a median follow-up of 12.8 years (interquartile range 12.3–13.1), a total of 194 primary endpoints were identified. Compared to participants with ≤ 2 ideal metrics, HR (95% CI) for major cardiovascular events among participants meeting ≥ 5 metrics was 0.32 (0.17–0.60) with RAP (95% CI) of − 14.4 years (− 22.9, − 5.9). CONCLUSIONS: Greater adherence to ICVH metrics was associated with lower cardiovascular risk among Spanish adults of the RIVANA cohort. Adherence to ideal metrics may substantially delay cardiovascular risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02417-x. BioMed Central 2022-07-05 /pmc/articles/PMC9254604/ /pubmed/35787272 http://dx.doi.org/10.1186/s12916-022-02417-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Fernandez-Lazaro, Cesar I.
Sayon-Orea, Carmen
Toledo, Estefania
Moreno-Iribas, Conchi
Guembe, María J.
Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort
title Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort
title_full Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort
title_fullStr Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort
title_full_unstemmed Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort
title_short Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort
title_sort association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a mediterranean population-based cohort
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254604/
https://www.ncbi.nlm.nih.gov/pubmed/35787272
http://dx.doi.org/10.1186/s12916-022-02417-x
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