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Published on: September 26, 2018
Age-Specific Relation of Cardiovascular Health Metrics With Incident Cardiovascular Disease
Hidetaka Itoh1, Hidehiro Kaneko2, Akira Okada3
1Department of Cardiovascular Medicine.
Insights
Cardiovascular health metrics strongly predict cardiovascular disease (CVD) events in younger adults. Optimizing lifestyle factors is crucial for primary CVD prevention, especially in individuals aged 20-49.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
- Age is a significant risk factor for CVD, but the impact of cardiovascular health (CVH) metrics across different age groups requires further investigation.
- Understanding age-related differences in CVH metric associations is crucial for targeted prevention strategies.
Purpose of the Study:
- To examine age-related differences in the association between cardiovascular health (CVH) metrics and incident cardiovascular disease (CVD).
- To assess the impact of modifiable risk factors on CVD events across various age categories.
- To determine the effectiveness of improving CVH metrics for primary CVD prevention in different age groups.
Main Methods:
- Analysis of a large claims database (JMDC) from 2005-2020, including over 2.7 million participants.
- Categorization of participants into three age groups: 20-49, 50-59, and 60-75 years.
- Assessment of ideal CVH metrics (e.g., non-smoking, healthy BMI, physical activity, normal blood pressure, glucose, and cholesterol) and their association with incident CVD events (myocardial infarction, angina pectoris, stroke, heart failure).
Main Results:
- A higher number of non-ideal CVH metrics was significantly associated with increased risk of MI, angina, stroke, and HF across all age groups.
- This association was more pronounced in younger individuals (20-49 years).
- The relative risk reduction for CVD events by improving CVH metrics decreased with increasing age, with the greatest reduction observed in the youngest group (0.51 for MI).
Conclusions:
- Cardiovascular health metrics are more strongly associated with incident CVD, including heart failure, in younger individuals.
- Optimizing modifiable risk factors and lifestyle choices in younger populations is paramount for primary CVD prevention.
- Age-specific approaches to CVH management may enhance the effectiveness of CVD prevention strategies.
Abstract:
We examined the age-related differences in cardiovascular health (CVH) metrics for incident cardiovascular disease (CVD). Analyses were conducted using data from the JMDC Claims Database from 2005 to 2020 (n = 2,728,427; mean age 44.9 ± 11.0 years; 56.2% men). Participants were categorized on the basis of age: 20 to 49 years (n = 1,800,161), 50 to 59 years (n = 644,703), and 60 to 75 years (n = 283,563). Ideal CVH metrics included nonsmoking, body mass index <25 kg/m2, physical activity at goal, not skipping breakfast, blood pressure <120/80 mm Hg, fasting plasma glucose <100 mg/dL, and total cholesterol <200 mg/dL. Over a mean follow-up of 1,194 ± 917 days, 5,988 myocardial infarction (MI), 53,409 angina pectoris, 26,530 stroke, and 52,712 heart failure (HF) events were recorded. Number of the nonideal CVH metrics was associated with incident MI, angina pectoris, stroke, and HF in all age categories. However, the association of the number of nonideal CVH metrics with incident CVD was modified by age categories and was more pronounced in participants aged 20 to 49 years. Similarly, the relative risk reduction at 1 year for each CVD event under the virtual condition that an individual with 2 nonideal CVH metrics has decreased them to zero, decreased with age. For example, relative risk reduction for MI was 0.51 in participants aged 20 to 49 years, 0.48 in those aged 50 to 59 years, and 0.40 in those aged 60 to 75 years. In conclusion, CVH metrics were more strongly associated with incident CVD including HF among younger individuals suggesting the importance of optimizing modifiable risk factors and lifestyles in young participants for the primary CVD prevention.
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