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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References
Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, Greenlund K, Daniels S, Nichol G, Tomaselli GF, Arnett DK, Fonarow GC, Ho PM, Lauer MS, Masoudi FA, Robertson RM, Roger V, Schwamm LH, Sorlie P, Yancy CW, Rosamond WD, American Heart Association Strategic Planning Task F, Statistics C. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond. Circulation 2010;121:586–613.
- Age dependent associations of risk factors with heart failure: pooled population based cohort study.BMJ. 2021; 372: n461
- Association of lipid, inflammatory, and metabolic biomarkers with age at onset for incident coronary heart disease in women.JAMA Cardiol. 2021; 6: 437-447
- Quantifying importance of major risk factors for coronary heart disease.Circulation. 2019; 139: 1603-1611
- Association of cardiovascular health metrics with subsequent cardiovascular disease in young adults.J Am Coll Cardiol. 2020; 76: 2414-2416
- Association of blood pressure classification using the 2017 American College of Cardiology/American Heart Association blood pressure guideline with risk of heart failure and atrial fibrillation.Circulation. 2021; 143: 2244-2253
- Risk of cardiovascular events after spouse's ICU admission.Circulation. 2020; 142: 1691-1693
- Fasting plasma glucose and subsequent cardiovascular disease among young adults: analysis of a nationwide epidemiological database.Atherosclerosis. 2021; 319: 35-41
- Cardiovascular health metrics of 87,160 couples: analysis of a nationwide epidemiological database.J Atheroscler Thromb. 2021; 28: 535-543
- Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study.Circulation. 2001; 103: 1245-1249
- Trends in cardiovascular health metrics and associations with all-cause and CVD mortality among US adults.JAMA. 2012; 307: 1273-1283
- Ideal cardiovascular health, mortality, and vascular events in elderly subjects: the three-city study.J Am Coll Cardiol. 2017; 69: 3015-3026
- Ideal cardiovascular health metrics and risk of cardiovascular disease or mortality: A meta-analysis.Int J Cardiol. 2016; 214: 279-283
- Ideal cardiovascular health and risk of cardiovascular events in the EPIC-Norfolk prospective population study.Eur J Prev Cardiol. 2016; 23: 986-994
- Associations of late adolescent or young adult cardiovascular health with premature cardiovascular disease and mortality.J Am Coll Cardiol. 2020; 76: 2695-2707
- Association between mortality and incidence rates of coronary heart disease and stroke: the Japan Public Health Center-based prospective (JPHC) study.Int J Cardiol. 2016; 222: 281-286
- Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies.Circulation. 2009; 119: 1892-1898
- Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals.Circulation. 2013; 128: 337-343
- Association of skipping breakfast with cardiovascular and all-cause mortality.J Am Coll Cardiol. 2019; 73: 2025-2032
- Possible association between eating behaviors and cardiovascular disease in the general population: analysis of a nationwide epidemiological database.Atherosclerosis. 2021; 320: 79-85
Article Info
Publication History
Published online: June 27, 2022
Received in revised form:
April 11,
2022
Received:
January 21,
2022
Footnotes
This work was supported by grants from the Ministry of Health, Labour and Welfare, Tokyo, Japan ( 21AA2007 ) and the Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan ( 20H03907 , 21H03159 , and 21K08123 ).
IRB Information: The Clinical Research Review Board of The University of Tokyo [2018-10862].
Identification
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