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Am Heart J. 2015 Mar;169(3):371-378.e1. doi: 10.1016/j.ahj.2014.12.017. Epub 2015 Jan 6.

Association of ideal cardiovascular health and calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study.

Author information

1
Division of Internal Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA. Electronic address: jrobbins3@partners.org.
2
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
3
Department of Radiology, Vanderbilt University, Nashville, TN.
4
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
5
Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT.
6
Department of Epidemiology, School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC.
7
Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL.
8
Section of Preventive Medicine & Epidemiology, Boston University, Boston, MA.
9
Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA.

Abstract

BACKGROUND:

The American Heart Association (AHA) established recommendations based on 7 ideal health behaviors and factors with the goal of improving cardiovascular health (CVH) and reducing both morbidity and mortality from cardiovascular disease by 20% by 2020. Few studies have investigated their association with subclinical coronary heart disease. We sought to examine whether the 7 AHA CVH metrics were associated with calcified atherosclerotic plaque in the coronary arteries.

METHODS:

In a cross-sectional design, we studied 1,731 predominantly white men and women from the National Heart, Lung, and Blood Institute Family Heart Study without prevalent coronary heart disease. Diet was assessed by a semiquantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac computed tomography. We defined prevalent CAC using an Agatston score of 100+ and fitted generalized estimating equations to calculate prevalence odds ratios of CAC.

RESULTS:

Mean age was 56.8 years, and 41% were male. The median number of ideal CVH metrics was 3, and no participant met all 7. There was a strong inverse relationship between number of ideal CVH metrics and prevalent CAC. Odds ratios (95% CI) for CAC of 100+ were 1.0 (reference), 0.37 (0.29-0.45), 0.35 (0.26-0.44), and 0.27 (0.20-0.36) among subjects with 0 to 1, 2, 3, and 4+ ideal CVH metrics, respectively (P = .0001), adjusting for sex, age, field center, alcohol, income, education, and energy consumption.

CONCLUSIONS:

These data demonstrate a strong and graded inverse relationship between AHA ideal CVH metrics and prevalent CAC in adult men and women.

PMID:
25728727
PMCID:
PMC4346707
DOI:
10.1016/j.ahj.2014.12.017
[Indexed for MEDLINE]
Free PMC Article

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