Abstract 15206: Application of a Lifestyle Based Score for CVD Risk Prediction to Young Adults in CARDIA
Introduction: The Healthy Heart Score (HHS), a lifestyle-based risk prediction tool, predicts cardiovascular disease (CVD) events in middle-aged adults. We evaluated the performance of the HHS for CVD risk prediction in a younger cohort.
Method: We applied the HHS to 4899 white and black adults ages 18-30 years in the Coronary Artery Risk Development in Young Adults (CARDIA) study in 1985-6. The HHS includes age, smoking status, body mass index, alcohol intake (g/d), exercise (hours/week) and a diet score composed of self-reported daily intake of cereal fiber, fruits/vegetables, nuts, sugar-sweetened beverages, and red/processed meats. We calculated the HHS using sex-specific beta-coefficients derived from the Nurses’ Health Study (women) and Health Professionals Follow-up Study (men). We tested the utility of the HHS to predict 25-year incidence of ASCVD (CHD death, nonfatal MI, fatal/nonfatal stroke) in the total population, in race and sex-specific groups, and in those with and without clinical CVD risk factors. We assessed model discrimination with Harrell’s C-statistic and model calibration with Hosmer-Lemeshow’s chi-square.
Result: Mean (SD) age at baseline was 24.8 (3.6) years; 55% were female, 51% were black, and 9% had at least one CVD risk factor at baseline. During a mean of 26 years follow-up, 65 CVD events occurred in women and 99 in men. The HHS showed moderate discrimination for CVD risk prediction in this diverse population of mostly healthy young adults; it performed better in men than in women and in whites than in blacks (Table). The HHS was adequately calibrated overall and within each sub-group, except those who already had ≥1 baseline CVD risk factor.
Conclusion: The HHS performs moderately well predicting 25 year CVD risk in young adults, especially those without any established CVD risk factors. Its reliance on self-reported, modifiable lifestyle factors makes it an attractive tool for risk assessment and counseling for CVD primary prevention.
Author Disclosures: H.C. Gooding: Research Grant; Significant; K23 HL122361-02. H. Ning: None. M. Gillman: None. D. Lloyd-Jones: None. C. Shay: None. D.C. Goff: None. S. Chiuve: Employment; Modest; Shire Biopharmaceuticals.
- © 2016 by American Heart Association, Inc.