Ideal Cardiovascular Health During Adult Life and Cardiovascular Structure and Function Among the Elderly
Background—Higher AHA cardiovascular health score (CVHS) predicts lower incidence of cardiovascular disease (CVD). However, the relationship of CVHS attainment through mid- to late-life with CVD prevalence and cardiovascular structure and function in late life is not well described.
Methods and Results—The following six ideal CV health metrics were assessed in Atherosclerosis Risk in Communities (ARIC) study participants at five examination visits between 1987 and 2013: nonsmoking, body mass index <25 kg/m2, untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mmHg, fasting blood glucose <100 mg/dL, and ideal physical activity. Attainment over time was assessed as the percent of maximum possible CVHS metrics achieved at Visits 1 though 5, the slope of change in CVHS per decade of follow-up, and CVHS trajectory through follow-up. At Visit 5, participant groups were characterized with respect to CVD prevalence (n = 6,520) and echo measures of cardiac structure and function (n= 5,903 free of CV disease). CVHS was low at baseline and declined with age. Both greater CVHS attainment, and improvement in CVHS during follow-up, were associated with a lower prevalence of CVD and better LV structure, systolic and diastolic function at Visit 5.
Conclusions—Greater attainment of, and improvements in, ideal CV health through mid- to late-life are associated with lower CVD prevalence and better cardiovascular structure and function when elderly. These findings highlight the importance of consistent primordial and primary prevention efforts throughout mid- to late-life as a potential intervention to decrease the burden of CVD among the elderly.
- Received June 8, 2015.
- Revision received August 26, 2015.
- Accepted August 31, 2015.