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Ideal Cardiovascular Health and Subclinical Markers of Carotid Structure and Function: The Paris Prospective Study
Bamba Gaye1, Hazrije Mustafic2, Stéphane Laurent2
1From the INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, France (B.G., S.L., M.C.P., C.G., M.T., P.B., X.J., J.P.E.); Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, France (B.G., S.L., M.C.P., C.G., M.T., P.B., X.J., J.P.E.); APHP, Georges Pompidou European Hospital, Pharmacology Departments, Paris, France (S.L., P.B.); Preventive and Clinical Investigation Center, Paris, France (F.T., B.P.); APHP, Georges Pompidou European Hospital, Cardiology Department, Paris, France (X.J.); and Department of Cardiology, University Hospital of Geneva, Switzerland (H.M.). m.bamba.gaye@gmail.com.
Insights
Maintaining ideal cardiovascular health (CVH) is linked to better vascular structure and function. This suggests that adhering to American Heart Association (AHA) guidelines for CVH may reduce the risk of cardiovascular disease.
Area of Science:
- Cardiovascular Health
- Vascular Biology
- Preventive Cardiology
Background:
- Subclinical markers of vascular structure and function independently predict cardiovascular disease (CVD).
- Cardiovascular health (CVH) is defined by the American Heart Association (AHA) using metrics like smoking, physical activity, BMI, diet, blood glucose, cholesterol, and blood pressure.
- The relationship between ideal CVH and subclinical vascular markers requires further investigation.
Purpose of the Study:
- To test the hypothesis that ideal CVH is associated with fewer subclinical vascular abnormalities compared to poor CVH.
- To evaluate the association between ideal CVH and specific carotid artery parameters.
Main Methods:
- A cohort of 9155 participants undergoing health checkups in Paris were assessed.
- Carotid parameters (intima-media thickness, plaque presence, elastic modulus, distensibility) were measured using high-precision echotracking.
- Participants were categorized into poor, intermediate, and ideal CVH based on AHA criteria; multivariable logistic regression was used for analysis.
Main Results:
- Ideal CVH was present in 10.11% of participants (mean age 59.5 years, 39% female).
- Compared to poor CVH, ideal CVH was significantly associated with lower common carotid artery intima-media thickness (OR=1.64), absence of carotid plaques (OR=2.14), lower Young's elastic modulus (OR=2.43), and higher carotid distensibility coefficient (OR=2.90).
- These associations remained significant after adjusting for age, sex, education, and living alone.
Conclusions:
- Ideal cardiovascular health is associated with significantly less arterial stiffness and thickness in community-dwelling adults aged 50-75.
- These findings suggest that maintaining ideal CVH may contribute to a reduced risk of cardiovascular diseases.
- Promoting ideal CVH could be a key strategy in preventing vascular complications.
Objective:
We hypothesized that subclinical markers of vascular structure and function, which are independent predictors of cardiovascular disease, would be less frequent in subjects with ideal than poor cardiovascular health (CVH) as defined by the American Heart Association (AHA).
Approach And Results:
Carotid parameters were measured using high-precision echotracking device in 9155 nonreferred participants attending a health checkup in a large health center in Paris (France) between 2008 and 2012. According to the AHA, participants with 0 to 2, 3 to 4, and 5 to 7 metrics (smoking, physical activity, body mass index, diet, blood glucose and total cholesterol, blood pressure) at the ideal level were categorized as having poor, intermediate, and ideal CVH. Carotid parameters were dichotomized according to their median value, and multivariable logistic regression analysis was performed. Mean age was 59.5 (SD 6.3) years; 39% were females, and ideal CVH was present in 10.11% of the study participants. After adjustment for age, sex, education, and living alone and compared with a poor CVH, an ideal CVH was associated with lower common carotid artery intima-media thickness (odds ratio=1.64; 95% confidence interval 1.40, 1.93), absence of carotid plaques (odds ratio=2.14; 95% confidence interval 1.60, 2.87), lower Young's elastic modulus (odds ratio=2.43; 95% confidence interval 2.07, 2.84), and higher carotid distensibility coefficient (odds ratio=2.90; 95% confidence interval 2.47, 3.41).
Conclusions:
In community subjects aged 50 to 75 years, ideal CVH was associated with substantially less arterial stiffness and thickness. These associations might contribute to the lower risk of cardiovascular diseases in subjects with ideal CVH.