Ideal Cardiovascular Health Index and Its Determinants in a Rural South African Population

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The ideal cardiovascular health index (CVHI) assesses cardiovascular health through factors like smoking, BMI, physical activity, blood pressure, glucose, cholesterol, and diet.
• Cardiovascular diseases remain a significant global health concern, necessitating effective population-level assessment tools.

Purpose of the Study:

• To evaluate cardiovascular health using the CVHI in a rural African population.
• To identify determinants of cardiovascular health within this population.
• To correlate the CVHI with carotid intima-media thickness (CIMT) as a marker of atherosclerosis.

Main Methods:

• Cross-sectional analysis of baseline data from the Ndlovu Cohort Study in rural South Africa.
• Calculation of CVHI scores (0-7) based on favorable health factors.
• Logistic regression to identify associations between demographics, socioeconomic factors, HIV status, and good CV health (5-7 factors).
• Comparison of mean CIMT across different CVHI score categories.

Main Results:

• The study included 1927 participants (mean age 38.7 years).
• Average CVHI score was 4.4, with 53% achieving good CV health.
• Glucose and cholesterol levels were optimal; diet quality was lowest.
• Younger age, higher education, and HIV positivity were associated with good CV health.
• CVHI scores demonstrated good agreement with CIMT.

Conclusions:

• More than half the study population exhibited good cardiovascular health, outperforming global averages for similar rural African cohorts.
• The CVHI shows potential as a surrogate marker for cardiovascular risk, evidenced by its correlation with CIMT.
• Educational attainment is crucial for health promotion, and HIV-positive individuals may benefit from enhanced chronic disease management leading to better CVH.