Temporal Trends in Cardiovascular Health in Australians With a History of Cardiovascular Diseases

Changes in cardiovascular health (CVH) in people with previous cardiovascular disease (CVD), including stroke or heart disease may reflect the success of secondary prevention strategies. This has not been examined among adult Australians over time.

We included people aged >18 years from National Health Surveys (NHSs) in 2011-2012, 2014-2015, 2017-2018, and 2022 with a self-reported history of stroke or heart disease. At each time point, five items (smoking status, blood pressure [BP], body mass index [BMI], diet and physical activity [PA]) aligned with the American Heart Association's guidelines were scored as 0 "poor", 1 "intermediate", or 2 "ideal". An overall CVH score summing these items for each time point was grouped as poor (scores 0-4), intermediate (5-6), or ideal (7-10). We examined changes in the proportion of people with "ideal" or "intermediate" CVH score, compared to "poor" scores over time using multinomial logistic regression analyses reporting the risk ratio (RR 95% confidence interval [CI]) for years 2014-2015, 2017-2018, and 2022 compared to 2011-2012, adjusting for covariates (sex, age, socioeconomic status, marital status, education, and occupation).

There were n=78,071 across the NHSs with 6%-7% (n=4,192) having a history of stroke or heart disease and included in the analysis. There was no change in the proportion with an "ideal" CVH score over the four surveys, but an increase in the likelihood of having an intermediate score, compared to a poor score in 2022, and compared to reference survey period (2011-2012) (RR_adjusted 1.38; 95% CI 1.06-1.81).

Ideal CVH prevalence remained and did not change significantly over time in people with a history of CVD. There is an urgent need for better secondary management efforts to manage risk factors and reduce recurrent CVD.