Changes in Cardiovascular Health during Young Adulthood and Subclinical Atherosclerosis in Middle Age: The CARDIA Study.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Global Heart Pub Date : 2023-03-17 eCollection Date: 2023-01-01 DOI:10.5334/gh.1179

Xiaomin Ye, Zhenyu Xiong, Jiaying Li, Yifen Lin, Peihan Xie, Xiangbin Zhong, Rihua Huang, Xiaodong Zhuang, Xinxue Liao

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Abstract

Background and aims: The benefits of reaching ideal cardiovascular health (CVH) are well known, but it is unclear whether positive CVH changes from young adulthood to middle age reduce subclinical atherosclerosis risk. This study examined associations of changes in CVH from young adulthood to middle age and CVH in young adulthood with subclinical atherosclerosis.

Methods: Data was analyzed from the Coronary Artery Risk Development in Young Adults (CARDIA) study. CVH was examined at years 0 and 20 using Life Simple 7 metrics from AHA guideline. Coronary artery calcium (CAC) was identified at years 20 and 25. Carotid intima-media thickness (IMT) was identified at year 20.

Results: Among 2,935 participants (56.2% women, 46.7% black), the change of CVH score was -1.26 (2.13). For per 1-unit increase in CVH at baseline, the adjusted odds ratios (ORs) of presence of CAC and IMT were 0.81 (95% CI 0.78, 0.86) and 0.85 (95% CI 0.76, 0.94), respectively. For per 1-unit increase in CVH changes, the adjusted ORs of CAC and IMT were 0.86 (95% CI 0.82, 0.90) and 0.81 (95% CI 0.73, 0.90). Compared with stable moderate CVH, improvement from moderate to high was associated with a lower risk of CAC (0.64 [95% CI 0.43, 0.96]), while retrogression from moderate to low was associated with a higher risk of CAC (1.45 [95% CI 1.19, 1.76]).

Conclusions: Positive changes of CVH during young adulthood are associated with negative subclinical atherosclerosis risk in middle age, indicating the importance of reaching an ideal cardiovascular health status through young adulthood.

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青年期心血管健康变化与中年亚临床动脉粥样硬化：CARDIA 研究。

背景和目的：达到理想的心血管健康（CVH）的益处众所周知，但目前尚不清楚从青年期到中年期CVH的积极变化是否会降低亚临床动脉粥样硬化的风险。本研究探讨了从青年期到中年期CVH的变化以及青年期CVH与亚临床动脉粥样硬化的关系：方法：对青年冠状动脉风险发展（CARDIA）研究的数据进行了分析。采用 AHA 指南中的 "生命简单 7 "指标对 0 岁和 20 岁时的 CVH 进行了检测。在 20 岁和 25 岁时对冠状动脉钙质 (CAC) 进行鉴定。颈动脉内膜中层厚度（IMT）在第 20 年进行鉴定：在 2,935 名参与者（56.2% 为女性，46.7% 为黑人）中，CVH 分数的变化为-1.26（2.13）。基线 CVH 每增加 1 个单位，出现 CAC 和 IMT 的调整赔率比（ORs）分别为 0.81（95% CI 0.78，0.86）和 0.85（95% CI 0.76，0.94）。CVH变化每增加1个单位，CAC和IMT的调整ORs分别为0.86（95% CI 0.82，0.90）和0.81（95% CI 0.73，0.90）。与稳定的中度CVH相比，从中度到高度的改善与较低的CAC风险相关（0.64 [95% CI 0.43, 0.96]），而从中度到低度的倒退与较高的CAC风险相关（1.45 [95% CI 1.19, 1.76]）：结论：青壮年时期心血管健康状况的积极变化与中年时期亚临床动脉粥样硬化的消极风险有关，这表明在青壮年时期达到理想的心血管健康状况非常重要。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.