Abstract 16496: Ideal Cardiovascular Health is Inversely Associated With Incident Coronary Heart Disease and Stroke Events in Non-Institutionalized Elderly Subjects. The Three Cities Study
Introduction: The promotion of ideal cardiovascular health should concern all segments of the population, still its distribution and its association with outcomes is unknown in the elderly.
Hypothesis: We therefore aimed to describe the prevalence of ideal cardiovascular health and quantify its association with incident coronary heart disease (CHD) or stroke in community elderly subjects. We hypothesized that in the elderly the high prevalence of comorbidities and medications prescriptions might affect the prevalence of ideal cardiovascular health while the high-risk of death might challenge its association with vascular events.
Methods: Between 1999 and 2001, 9294 non- institutionalized men and women aged 65 years and over were included in the Three City Study, a prospective observational multisite French cohort. Participants were followed over 10 years and incident events were validated. The American Heart Association 7-item tool includes 4 health behaviors (smoking, body weight, physical activity, optimal diet) and 3 health factors (blood cholesterol, blood glucose, blood pressure), each categorized in poor, intermediate or ideal level. The presence of 0-2, 3-4 and 5-7 metrics at the ideal level defined poor, intermediate and ideal cardiovascular health respectively.
Results: The mean age was 74.0 years (5.4) and 40%% were men. Ideal cardiovascular health was present in 3.5% of the study participants at baseline, 4.6% in women vs. 1.9% in men (p<0.001), and decreased with age from 5.2% to 2.4% across tertiles of age (p<0.001). After a median follow-up of 8.5 years, 1731 had died and 869 developed a first CHD or stroke event. In Cox proportional hazard model adjusted for age, sex, cities, education and living alone, the hazard ratios of combined CHD and stroke for intermediate and ideal compared to poor cardiovascular health were 0.72 (95% CI: 0.63-0.83) and 0.26 (95% CI: 0.13-0.53) respectively (p for trend<0.001). Results remained unchanged after further adjustment for physical incapacity over time or when considering competing risk by death.
Conclusion: To the best of our knowledge, this is the first study conducted in the elderly population showing a substantial reduced risk of CHD and stroke associated with ideal cardiovascular health.
Author Disclosures: B. Gaye: None. M. Canonico: None. M. Perier: None. C. Samieri: None. C. Berr: None. J. Dartigues: None. C. Tzourio: None. A. Elbaz: None. J. Empana: None.
- © 2016 by American Heart Association, Inc.