Key result
Higher TC/HDL-c strongly links to increased heart-age-based avoidable lost life years.
Why the study?
Cardiovascular prevention requires non-invasive, low-cost tools to identify high-risk individuals, prompting an evaluation of the association between atherogenic indices and heart age.
Are atherogenic indices associated with high values of avoidable lost life years heart age in Spanish workers?
Cross-Sectional (n=139,634)
Yes
Are atherogenic indices associated with high values of avoidable lost life years heart age in Spanish workers?
Atherogenic indices, particularly the total cholesterol/HDL-c ratio, are strongly associated with increased 'heart age' and may serve as useful tools for communicating cardiovascular risk to patients.
May support atherogenic indices for CV risk communication in workers; hypothesis-generating for prospective validation.
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, accounting for one-third of all global deaths. The World Health Organization (WHO) asserts that prevention is the most effective strategy to combat CVD, emphasizing the need for non-invasive, low-cost tools to identify individuals at high risk of CVD. Atherogenic indices and heart age (HA) are valuable tools for assessing cardiovascular risk (CVR). The aim of our study was to evaluate the association between atherogenic indices and HA. METHODS: A cross-sectional study was conducted involving 139,634 Spanish workers to determine the association between three atherogenic indices and HA. ROC curves were employed to identify the cut-off values for the various atherogenic indices used to estimate high HA. The cut-off points, along with their sensitivity, specificity, and Youden index, were determined, and the area under the curve (AUC) was calculated. RESULTS: As the values of the atherogenic indices increased, so did the risk of having elevated avoidable lost life years (ALLY) HA. In the ROC curve analysis, the AUC with the best results corresponded to the total cholesterol/HDL-c atherogenic index, with an AUC of 0.803 in females and 0.790 in males. The LDL-c/HDL-c atherogenic index showed an AUC of 0.780 in women and 0.750 in men, with Youden indices around 0.4. When analyzing the AUC of the atherogenic index for triglycerides/HDL-c, the results were 0.760 in women and 0.746 in men. CONCLUSIONS: Atherogenic indices and HA show a close relationship, with an increase in these indices leading to a rise in HA values. Raising patient awareness that as their CVR levels increase, so does their HA may be useful in achieving some benefit in reducing CVR.
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Sastre-Alzamora et al. (2024) conducted a cross-sectional in Cardiovascular risk (n=139,634). Atherogenic indices (Total cholesterol/HDL-c, LDL-c/HDL-c, Triglycerides/HDL-c) vs. Lower values of atherogenic indices was evaluated on Prediction of high values of avoidable lost life years (ALLY) heart age (AUC 0.803 in females and 0.790 in males (for total cholesterol/HDL-c), p=<0.001). Higher values of atherogenic indices, particularly the total cholesterol/HDL-c ratio, were strongly associated with an increased risk of elevated avoidable lost life years heart age.
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