Association of the Duration of Ideal Cardiovascular Health Through Adulthood With Cardiometabolic Outcomes and Mortality in the Framingham Offspring Study
Key result
Every 5 years of intermediate or ideal midlife CVH links to ~27% lower CVD risk.
- HR 0.73
- 95% CI 0.63-0.85
- n=1,445
Why the study?
It was unclear whether the number of years spent in ideal cardiovascular health is associated with subsequent morbidity or mortality.
Does a longer duration of ideal cardiovascular health in midlife reduce the risk of cardiometabolic outcomes and mortality in adults?
Key Points
- To evaluate whether maintaining a higher cardiovascular health score for a longer duration in midlife is associated with a lower risk of hypertension, diabetes, chronic kidney disease, cardiovascular disease, and all-cause mortality.
- Prospective cohort analysis of 1,445 participants (mean age 60 years; 52% women) from the Framingham Heart Study Offspring cohort followed for a median of approximately 16 years (1991–2015).
- Assessed cardiovascular health (CVH) scores across examination cycles 5, 6, and 7 based on diet, physical activity, smoking, BMI, blood pressure, fasting glucose, and total cholesterol, categorizing scores as poor (0–7), intermediate (8–11), or ideal (12–14).
- Event counts after examination 7 were 348/795 for incident hypertension, 104/1,304 for diabetes, 198/918 for chronic kidney disease, 210/1,285 for CVD, and 300/1,445 for all-cause mortality.
- Each antecedent 5-year duration of intermediate or ideal CVH significantly reduced the hazard of hypertension (HR 0.67; 95% CI, 0.56–0.80), diabetes (HR 0.73; 95% CI, 0.57–0.93), chronic kidney disease (HR 0.75; 95% CI, 0.63–0.89), CVD (HR 0.73; 95% CI, 0.63–0.85), and all-cause mortality (HR 0.86; 95% CI, 0.76–0.97) compared with poor CVH.
Study Design
Type
Cohort (n=1,445)
Multicenter
No
Structured PICO
Does a longer duration of ideal cardiovascular health in midlife reduce the risk of cardiometabolic outcomes and mortality in adults?
P
Population
1445 participants from the community-based Framingham Heart Study Offspring investigation in Massachusetts, mean age 60, 52% women.
I
Intervention
Each antecedent 5-year duration of intermediate (score 8-11) or ideal (score 12-14) cardiovascular health (CVH) score in midlife.
C
Comparator
Living the same amount of time in poor CVH (score 0-7).
O
Outcome
Incident hypertension, diabetes, chronic kidney disease, cardiovascular disease (coronary heart disease, stroke, congestive heart failure, and peripheral artery disease), and all-cause mortality after the seventh examination.hard clinical
Main Result
Effect estimate: HR 0.73 (95% CI 0.63-0.85)
Maintaining intermediate or ideal cardiovascular health for longer durations in midlife significantly reduces the risk of subsequent cardiometabolic disease, cardiovascular events, and all-cause mortality.
Authors
Discussion
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Implication
Longer midlife CVH duration was associated with lower cardiometabolic risk; hypothesis-generating and requires prospective trials before changing practice.
Cite This Study
Corlin et al. (2020) conducted a cohort in Cardiovascular health (n=1,445). Intermediate or ideal cardiovascular health (CVH) score vs. Poor CVH score was evaluated on Incident cardiovascular disease (CVD) (HR 0.73, 95% CI 0.63-0.85). Each 5-year duration of intermediate or ideal cardiovascular health in midlife was associated with a lower risk of cardiovascular disease (HR 0.73; 95% CI 0.63-0.85) compared to poor CVH.