Abstract 13332: Ideal Cardiovascular Health Metrics Are Associated With Disability Independently of Vascular Conditions
Background: Individuals with disability comprise the largest health care consumer group in the US. Vascular and non-vascular conditions contribute independently to disability, but it is unclear whether vascular risk factors are associated with disability independently of vascular events. We examined whether the American Heart Association’s 7 ideal cardiovascular health (CVH) metrics were independently associated with disability in a nationally representative cohort.
Methods: Adults age>=20 years from the National Health and Nutrition Examination Survey 2005-2012 were included. Ideal CVH was calculated as a composite of 7 measures, each scored from 0-2. Primary predictors were number of ideal CVH metrics and score of CVH metrics. The outcome was a dichotomous score from 20 activities of daily living (ADL) and instrumental ADLs. Unadjusted and adjusted weighted logistic models estimated associations between ideal CVH and disability. Secondarily, interactions were tested and each disability item was tested separately.
Results: The total cohort included 22692 participants; mean age was 46.9 years. Cardiac disease and stroke were present in 6.6% and 2.8%; 90.3% had poor physical activity and 89.9% poor diet. Among 3975 individuals with full data on all 7 CVH metrics, the mean number of ideal CVH metrics was 3.12 (95% CI 3.05-3.20) and ideal CVH score was 7.6 (7.5-7.7). In fully adjusted models, the OR for disability was 0.90 (95% CI 0.83-0.98) per point increase in ideal CVH score, and 0.84 (0.73-0.97) per additional number of ideal CVH metrics. There were significant interactions with ideal CVH measures for cardiac disease (p =0.007 for ideal CVH score and 0.01 for number of ideal CVH indicators) and stroke (p= 0.12 and 0.11 respectively). Among those with cardiac disease and stroke, there was a paradoxical trend for increased odds of disability for increasing values of CVH. For the majority of disability items, there was an inverse relationship with ideal CVH metrics.
Conclusions: Both ideal CVH score and number of ideal CVH metrics were strongly and significantly associated with reduced odds of disability independently of vascular and non-vascular conditions. Poorer CVH may cause subclinical vascular disease resulting in disability.
Author Disclosures: S. Devulapalli: None. H. Shoirah: None. M.S. Dhamoon: None.
- © 2015 by American Heart Association, Inc.