Meeting greater number of recommended cardiovascular health factors linked with lower risk of death

March 17, 2012

In a study that included a nationally representative sample of nearly 45,000 adults, participants who met more of seven recommended cardiovascular health behaviors or factors (such as not smoking, having normal cholesterol levels, eating a healthy diet), had a lower risk of death compared to participants who met fewer factors, although only a low percentage of adults met all seven factors, according to a study appearing in JAMA. The study is being published early online to coincide with its presentation at a specialty meeting of the American Heart Association.

"Cardiovascular disease (CVD) is the leading cause of deaths in the United States [greater than 800,000, or about 1 in 3 overall deaths/year], with estimated annual direct and overall costs of $273 billion and $444 billion, respectively," according to background information in the article. The (AHA) recently published recommendations aimed at improving cardiovascular health and reducing deaths from CVD in the United States by encouraging the general population to meet seven defined ideal cardiovascular or factors (for this study, called cardiovascular health metrics). The metrics are not smoking; being physically active; having , and total cholesterol levels, and weight; and eating a healthy diet.

Quanhe Yang, Ph.D., of the , Atlanta, and colleagues conducted a study to examine the trends of these health metrics and estimated their associations with risk of all-cause and CVD mortality. The study included 44,959 U.S. adults (age 20 years or older), using data from the and (NHANES) 1988-1994,1999-2004, and 2005-2010 and the NHANES III Linked Mortality File (through 2006).

The researchers found that regarding trends over the study period, the prevalence of current smoking continued to decline since 1988. However, the desirable level of untreated blood pressure and total cholesterol level remained unchanged, and the prevalence of desirable levels of body mass index (BMI) (less than 25) and fasting glucose continued to decline for the study period.

Few participants met all 7 cardiovascular health metrics (2.0 percent in 1988-1994, 1.2 percent in 2005-2010). Younger participants, women, non-Hispanic whites, and those with higher education levels tended to meet a greater number of cardiovascular health metrics.

The authors found that meeting a greater number of cardiovascular health metrics was associated with a significantly lower risk of all-cause, CVD, and ischemic heart disease (IHD) mortality. "During a median [midpoint] of 14.5 years of follow-up in the NHANES III Linked Mortality File cohort, participants who met 6 or more vs. 1 or fewer cardiovascular health metrics had a 51 percent lower risk of all-cause mortality, a 76 percent lower risk of CVD mortality, and a 70 percent lower risk of IHD mortality. In addition, meeting a greater number of cardiovascular health metrics also appeared to be associated with lower risk for all-cancer mortality."

The researchers add that a significant interaction between cardiovascular health metrics and age group (less than 60 vs. 60 years or older) on CVD mortality suggested that meeting cardiovascular health metrics might offer greater protection against premature CVD deaths among younger participants.

"In summary, our findings indicate that the presence of a greater number of cardiovascular health metrics was associated with a graded and significantly lower risk of total and CVD mortality," the authors write.

"Healthy People 2020 and the AHA's national strategy to reduce CVD morbidity and mortality by 20 percent by 2020 through promoting ideal cardiovascular health metrics represents a great challenge but also an achievable goal. Coordinated efforts, such as the recently announced Million Hearts initiative, align CVD prevention and control activities across the public and private sectors, creating opportunities to reduce the burden of CVD across a large segment of the population."

In an accompanying editorial, Donald M. Lloyd-Jones, M.D., Sc.M., of the Northwestern University Feinberg School of Medicine, Chicago, writes that regarding what can be done to improve cardiovascular health, a proposed concept to shift the population distribution toward greater health is the key.

"Despite the apparent difficulties in achieving the goal, there is much to be optimistic about, and opportunities abound for physicians, policy makers, and consumers to support improvements in cardiovascular health. Continued focus through the health care system on meeting primary and secondary prevention targets is critically important, so that individuals at risk can take one step forward from poor to intermediate cardiovascular health. Advocacy will be needed for new public health and social policies to tilt the playing field toward healthier choices, so more individuals can move from intermediate to ideal levels or maintain ideal cardiovascular health. The debate over this year's farm bill, which will set policy for years to come, represents an opportunity for advocacy for and a healthier food supply for all. Efforts to reduce sodium in the food supply are ongoing on multiple fronts."

Explore further: Study evaluates relationship of urinary sodium with health outcomes

More information: JAMA. 2012;307[12]:doi:10.1001/JAMA.2012.339 ; doi:10.1001/JAMA.2012.361


Related Stories

Study evaluates relationship of urinary sodium with health outcomes

May 3, 2011
In a study conducted to examine the health outcomes related to salt intake, as gauged by the amount of sodium excreted in the urine, lower sodium excretion was associated with an increased risk of cardiovascular death, while ...

More red meat consumption appears to be associated with increased risk of death

March 12, 2012
Eating more red meat appears to be associated with an increased risk of all-cause mortality and death from cardiovascular disease and cancer, but substituting other foods including fish and poultry for red meat is associated ...

Middle-age blood pressure changes affect lifetime heart disease, stroke risk

December 19, 2011
An increase or decrease in your blood pressure during middle age can significantly impact your lifetime risk for cardiovascular disease (CVD), according to research in Circulation: Journal of the American Heart Association.

Elevated risk factors linked to major cardiovascular disease events across a lifetime

January 26, 2012
In one of the largest-ever analyses of lifetime risks for cardiovascular disease (CVD), researchers have found that middle-aged adults who have one or more elevated traditional risk factors for CVD, such as high blood pressure, ...

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.