Ideal Cardiovascular Health Predicts Lower Risks of Myocardial Infarction, Stroke, and Vascular Death across Whites, Blacks and Hispanics: the Northern Manhattan Study
Background—Evidence regarding the relationship of cardiovascular health (CVH) defined by the American Heart Association (AHA) and specific cardiovascular outcomes is lacking, particularly among Hispanics. This study sought to evaluate the relationship between the number of ideal CVH metrics and cardiovascular risk, overall and by event subtype, in a multiethnic community-based prospective cohort.
Methods and Results—2981 subjects (mean age 69±10 years, 54% Caribbean Hispanic, 25% black, 21% white) free of myocardial infarction (MI) and stroke at baseline in the Northern Manhattan Study were prospectively followed (median follow-up 11 years). The relationship between the number of ideal CVH metrics and the risk of cardiovascular disease (CVD), including MI, stroke and vascular death was investigated. Overall, a strong gradient relationship was observed between the adjusted hazard ratios for CVD and the number of ideal CVH metrics: 0.73 (95% CI: 0.60-0.89), 0.61 (0.50-0.76), 0.49 (0.38-0.63) and 0.41 (0.26-0.63), respectively, for those having 2, 3, 4, and 5-6 ideal CVH metrics compared with those having 0-1 ideal CVH metrics (P for trend <0.0001). Similar graded relationships were found between the number of ideal CVH metrics and the adjusted incidence rate for each specific outcome and among whites, blacks, and Caribbean Hispanics.
Conclusions—Our findings demonstrated a steep gradient relationship between ideal CVH and individual CVD endpoints, including stroke, which was similar for whites, blacks and Caribbean Hispanics. This evidence supports the application of the AHA ideal cardiovascular health metrics for CVD risk assessment and health promotion for all Americans regardless of race-ethnic background.
- Received November 29, 2011.
- Accepted April 16, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited