Abstract 15462: Ideal Cardiovascular Health and Cardiovascular and Stroke Risk in Whites, Blacks and Hispanics: the Northern Manhattan Study
Background and Objective: To improve the cardiovascular health of all Americans by 20% by 2020, the AHA defined the metrics of ideal, intermediate and poor cardiovascular health for 7 health factors. Evidence regarding the relationship of ideal cardiovascular health (ICVH) and cardiac outcomes has largely been derived from white and some Black cohorts, but is lacking in Hispanics. We evaluated the gradient between the number of ICVH factors and the risk of cardiovascular diseases (CVD: MI, stroke or vascular death) across three race-ethnic groups from a community-based cohort.
Methods: Using AHA metrics, we classified 2981 Northern Manhattan Study participants free of MI and stroke (mean age 69±10 years, 64% female, 54% Hispanic, 25% non-Hispanic black and 21% non-Hispanic white) into five ICVH groups (0-1: 19%, 2: 32%, 3: 30%, 4: 14%, and 5-7: 5%) based on the number of ICVH factors present at baseline. This prospective cohort had a median follow-up time of 11 years. Age-, sex- and/or race-ethnicity-adjusted incidence of CVD was calculated using Poisson regression and hazard ratios (HR) of CVD were estimated using Cox proportional regression stratified by ICVH groups.
Results: The adjusted CVD incidence rate was 41.3, 30.4, 25.9, 20.7 and 17.6 per 1000 person-years, respectively, for those having 0-1, 2, 3, 4 and 5-7 ICVH factors. There was a strong protective gradient of the adjusted HR for CVD according to the number of ICVH factors: 0.73 (95%CI: 0.60-0.89), 0.61(0.50-0.76), 0.49(0.38-0.63) and 0.41(0.26-0.63), respectively, for those having 2, 3, 4, and 5-7 ICVH factors compared with those having 0-1 ICVH factors (P for trend <0.0001). No significant interaction was found between the number of ICVH factors and sex and between the number of ICVH factors and race-ethnicity. The analysis of individual CVD events showed similar protective gradient relationships.
Conclusion: Our findings demonstrated a clear gradient relationship between ideal cardiovascular health and CVD risk across race-ethnic groups. This evidence supports the application of the AHA ideal cardiovascular health metrics for CVD risk assessment and health promotion for all Americans regardless of race and ethnic backgrounds.
- © 2011 by American Heart Association, Inc.