Associations of Late Adolescent or Young Adult Cardiovascular Health With Premature Cardiovascular Disease and Mortality.
Associations of Late Adolescent or Young Adult Cardiovascular Health With Premature Cardiovascular Disease and Mortality.
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DOI：
10.1016/j.jacc.2020.10.002
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发表时间：
2020-12-08
影响因子：
24
通讯作者：
Lloyd-Jones DM
中科院分区：
文献类型：
--
作者：
Perak AM;Ning H;Khan SS;Bundy JD;Allen NB;Lewis CE;Jacobs DR Jr;Van Horn LV;Lloyd-Jones DM
在青春期或成年早期进行测量时，心血管健康 (CVH) 与未来的亚临床 CVD 相关，但缺乏有关 CVD 事件或死亡率的数据。我们研究了 18-30 岁 CVH 与过早 CVD 和死亡率的关联。我们分析了年轻人冠状动脉风险发展研究的数据。使用 Life’s Simple 7 指标在基线（1985-1986）对 CVH 进行评分，分为高（12-14 分）、中（8-11）或低（0-7）。经过 32 年的随访，对 CVD 事件和特定原因死亡率进行了判定。我们使用 Cox 模型估计调整后的关联，并按 CVH 类别计算事件发生率和人群归因分数 (PAF)。在 4,836 名参与者中（平均年龄 24.9 岁，54.8% 女性，50.5% 黑人，平均教育年限 15.2 年），基线 CVH 较高（良好）的人占 28.8%，中等的人占 65.0%，低的人占 6.3%。随访期间，发生 306 例 CVD 事件和 431 例死亡。高（对比低）CVH 的调整后 HR（95% CI）对于 CVD 为 0.14（0.09-0.22），对于 CVD 死亡率为 0.07（0.03-0.19）；中/低（对比高）CVH 的 PAF 对于 CVD 为 0.63（0.47-0.74），对于 CVD 死亡率为 0.81（0.55-0.92）。心血管疾病死亡率。在CVH高的个体中，不同社会人口亚组的事件发生率较低（例如，CVD发生率/1000人年：18-24岁，0.64；25-30岁，0.65；男性，1.04；女性，0.36；黑人，0.90；白人，0.50；≤高中教育，1.00；白人，1.00。 >高中，0.61）。青春期后期/青年时期的高 CVH 与 32 年内极低的过早 CVD 发生率和死亡率相关，这表明维持高 CVH 至关重要。我们根据 Life's Simple 7 调查了 18-30 岁心血管健康 (CVH) 与过早 CVD 和 32 岁以上死亡率之间的关系。在 4,836 名参与者中，29% 的基线 CVH 为高（良好），65% 为中等，6% 为低。高（与低）CVH 的 CVD 调整后 HR 为 0.14（95% CI，0.09-0.22），中/低（与高）CVH 的人群归因分数为 0.63（0.47-0.74）。在具有高 CVH 的个体中，按年龄、性别、种族和教育程度定义的亚组的 CVD 发生率较低，这表明在整个儿童期至成年早期保持高 CVH 的潜在影响。青春期或成年早期良好的心血管健康与 32 年来极低的过早 CVD 发生率和死亡率相关。高级作者的 Twitter 账号：@dmljmd
When measured in adolescence or young adulthood, cardiovascular health (CVH) is associated with future subclinical CVD, but data are lacking regarding CVD events or mortality. We examined associations of CVH at age 18–30 years with premature CVD and mortality. We analyzed data from the Coronary Artery Risk Development in Young Adults study. CVH was scored at baseline (1985–1986) using Life’s Simple 7 metrics and categorized as high (12–14 points), moderate (8–11) or low (0–7). CVD events and cause-specific mortality were adjudicated over 32 years’ follow-up. We estimated adjusted associations using Cox models and calculated event rates and population attributable fractions (PAFs) by CVH category. Among 4,836 participants (mean age 24.9 years, 54.8% female, 50.5% Black, mean education 15.2 years), baseline CVH was high (favorable) in 28.8%, moderate in 65.0%, and low in 6.3%. During follow-up, 306 CVD events and 431 deaths occurred. The adjusted HRs (95% CI) for high (vs low) CVH were 0.14 (0.09–0.22) for CVD and 0.07 (0.03–0.19) for CVD mortality, and the PAFs for moderate/low (vs high) CVH were 0.63 (0.47–0.74) for CVD and 0.81 (0.55–0.92) for CVD mortality. Among individuals with high CVH, event rates were low across sociodemographic subgroups (e.g., CVD rates/1000 person-years: age 18–24, 0.64; age 25–30, 0.65; men, 1.04; women, 0.36; Blacks, 0.90; Whites, 0.50; ≤high-school education, 1.00; >high-school, 0.61). High CVH in late adolescence/young adulthood was associated with very low rates of premature CVD and mortality over 32 years, indicating the critical importance of maintaining high CVH. We investigated associations of cardiovascular health (CVH), based on Life’s Simple 7, at age 18–30 years with premature CVD and mortality over 32 years. Among 4,836 participants, baseline CVH was high (favorable) in 29%, moderate in 65%, and low in 6%. The adjusted HR for CVD was 0.14 (95% CI, 0.09–0.22) for high (vs low) CVH, and the population attributable fraction for moderate/low (vs high) CVH was 0.63 (0.47–0.74). Among individuals with high CVH, CVD rates were low across subgroups defined by age, sex, race, and education, indicating the potential impact of maintaining high CVH throughout childhood into young adulthood. Favorable cardiovascular health in adolescence or young adulthood was associated with very low rates of premature CVD and mortality over 32 years. Twitter handle for Senior Author: @dmljmd
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影响因子：
39
作者：
Gooding, Holly C.;Ning, Hongyan;Chiuve, Stephanie
通讯作者：
Chiuve, Stephanie
DOI：
10.1016/0197-2456(91)90002-4
发表时间：
1991-02-01
期刊：
Controlled clinical trials
影响因子：
--
作者：
Cutter, G R;Burke, G L;Manolio, T A
通讯作者：
Manolio, T A
影响因子：
37.8
作者：
Liu, Kiang;Daviglus, Martha L.;Lloyd-Jones, Donald M.
通讯作者：
Lloyd-Jones, Donald M.
DOI：
10.1016/j.echo.2015.07.026
发表时间：
2015-12-01
影响因子：
6.5
作者：
Desai, Chintan S.;Ning, Hongyan;Lloyd-Jones, Donald M.
通讯作者：
Lloyd-Jones, Donald M.
影响因子：
37.8
作者：
Laitinen, Tomi T.;Pahkala, Katja;Juonala, Markus
通讯作者：
Juonala, Markus