Abstract 15315: Ideal Cardiovascular Health: Associations With Biomarkers and Subclinical Disease,and Impact on Incidence of Cardiovascular Disease in the Framingham Offspring Study
Background: Limited data suggest that the AHA Heart Healthy score (Life’s Simple 7TM; AHA score) is inversely associated with the incidence of cardiovascular disease (CVD). However, the biological mechanisms that underlie this association have not been elucidated.
Methods & Results: We investigated the association between the AHA Score and concentrations of circulating biomarkers and prevalent subclinical CVD (defined using a validated index consisting of at least one of the following: increased carotid intima media thickness or stenosis; left ventricular hypertrophy (by ECG or echocardiography) or systolic dysfunction (by echocardiography); microalbuminuria; and a reduced ankle-brachial index) in up to 2680 Framingham Offspring Study participants (mean age 58 years, 55% women). We hypothesized that any observed association between the AHA score and incident CVD may be mediated by the association between the score and biomarker levels and the presence of subclinical disease. Adjusting for age & sex, an ideal AHA score (non-smoking status, ideal body mass index, regular physical activity, healthy diet, and an optimal profile of total serum cholesterol, blood pressure, and glucose; range 0-7) was associated with: a. higher concentrations of natriuretic peptides (NT-proANP & B-type natriuretic peptide) and lower concentrations of plasminogen activator inhibitor-1, aldosterone, C-reactive protein, D-dimer, fibrinogen, homocysteine, and growth differentiation factor-15 levels (p<0.001 for all); and b. lower odds of subclinical disease (Odds Ratio 0.73 per unit increase in the AHA score, 95% CI 0.68, 0.80). The incidence of CVD (267 events over 16 years) was inversely associated with the baseline AHA score in age-, sex- adjusted models (Hazards ratio [HR] 0.78 per unit-increase in the AHA score, 95% CI 0.70, 0.86) that was slightly attenuated upon adjustment for biomarkers and subclinical disease (HR 0.88, 95% CI 0.79, 0.98).
Conclusion: In our prospective study of a large community-based sample, an ideal AHA score (indicating ideal cardiovascular health) was inversely associated with the incidence of CVD, an association partly attributable to its favorable impact on CVD biomarker levels and subclinical disease.
- © 2013 by American Heart Association, Inc.