Abstract P365: Use of AHA Ideal Cardiovascular Health vs. the Framingham Risk Score to Measure the Effect of a 24-month Lifestyle Intervention in Overweight and Obese Women
Introduction: The AHA definition of Ideal Cardiovascular Health (AHA) consists of 7 components (nonsmoker, BMI <25 kg/m2, cholesterol <200 mg/dL, SBP / DBP <120/80 mmHg, fasting glucose <100 mg/dL, meeting exercise and ≥4 of 5 dietary recommendations), while the Framingham Risk Score (FRS) uses age, lipids, blood pressure, diabetes, and smoking to estimate 10-year risk of coronary heart disease. Because it reflects an emphasis on primordial prevention, we hypothesized that the AHA metric would be better able to detect positive cardiovascular health changes as compared to the FRS during a lifestyle, weight loss intervention in otherwise healthy overweight and obese women.
Methods: Females (n=146, age 38 ± 5 years, BMI 33 ± 4 kg/m2) were randomized to a group-based lifestyle intervention, where all subjects were given an initial dietary prescription between 1200-1500 kcal/day and 1 of 4 exercise prescriptions based on intensity and duration. The study tracked progress through group meetings and calls over 24 months. Number of AHA components and the FRS were calculated at baseline and 24 months in the combined study population (no group differences were observed). Further analyses identified which components contributed to changes in each score.
Results: At 24 months, participants had maintained a 5% weight loss and there were no differences across groups. Changes in AHA score and FRS were correlated (r=-0.58, p<0.001). AHA score increased from 2.7 to 3.6 components (p<0.001), which resulted from more subjects meeting BMI, physical activity, cholesterol, and fasting glucose components. FRS was low and did not change (1.61% to 1.64%, p=0.652). This was due to increases in age but improvements in total and HDL cholesterol.
Conclusions: AHA score improved while FRS did not change in overweight and obese women participating in a lifestyle intervention, demonstrating the sensitivity of the AHA score for tracking positive health changes during an intervention in pursuit of primordial cardiovascular disease prevention.
- © 2013 by American Heart Association, Inc.