Cardiovascular Health and Protection Against CVD: More Than the Sum of the Parts?
Five years ago, the American Heart Association (AHA) launched a bold new initiative to begin promoting "cardiovascular health" in individuals and the population, in addition to continuing its decades-long fight to reduce cardiovascular and stroke mortality and decrease cardiovascular disease (CVD) risk. This shift in priorities came as a result of a "quiet revolution,"1 turning the adverse-outcomes-oriented and risk-focused perspective on its head, and instead focusing on creating the opportunity for promoting and preserving attributes associated with healthy, CVD-free longevity. The first-ever formal definition for this construct of cardiovascular health, published in 2010,2 was based on a broad review of the literature designed to determine groups of factors associated with excellent prognosis in long-term CVD-free survival and quality of life. It was designed to be simple, accessible and actionable, allowing all patients, clinicians and communities to focus on improving cardiovascular health. And it was crafted in a way so that it could be measured in the broad US population and major subgroups, monitored over time, and influenced by AHA's portfolio of programs.2 Although the entire spectrum of cardiovascular health was captured (from birth through living with CVD), a critical observation was the recognition of an "ideal cardiovascular health" phenotype that consisted of the simultaneous presence of ideal levels of seven health behaviors and health factors: smoking status, physical activity, eating pattern, body weight, and blood cholesterol, blood glucose and blood pressure levels.
- Received September 22, 2014.
- Accepted September 26, 2014.