Trends in cardiovascular health metrics and associations with long-term mortality among US adults with coronary heart disease

Qingping Xue; Shiyi Wu; Xingchen He; Yuli Huang; Yanjun Liu; Tong Yan; Nianwei Wu; Xue Yang; Ying Wen; Sheyu Li; Lauryn Cravens; Chun-Xia Yang; Jason H Y Wu; An Pan; Xiaohong Yang; Xiong-Fei Pan

doi:10.1016/j.numecd.2024.03.031

Trends in cardiovascular health metrics and associations with long-term mortality among US adults with coronary heart disease

Nutr Metab Cardiovasc Dis. 2024 Apr 5:S0939-4753(24)00149-2. doi: 10.1016/j.numecd.2024.03.031. Online ahead of print.

Authors

Qingping Xue¹, Shiyi Wu², Xingchen He³, Yuli Huang⁴, Yanjun Liu⁵, Tong Yan⁵, Nianwei Wu³, Xue Yang², Ying Wen⁶, Sheyu Li⁷, Lauryn Cravens⁸, Chun-Xia Yang⁹, Jason H Y Wu¹⁰, An Pan¹¹, Xiaohong Yang¹², Xiong-Fei Pan¹³

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Chengdu Medical College, Chengdu, Sichuan, China.
² Section of Epidemiology and Population Health, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Chengdu, Sichuan, China.
³ Section of Epidemiology and Population Health, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
⁴ Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, Guangdong, China.
⁵ Center for Obesity and Metabolic Health & Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu & The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China.
⁶ Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China.
⁷ Department of Endocrinology and Metabolism, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
⁸ Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁹ Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Chengdu, Sichuan, China.
¹⁰ School of Population Health and The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
¹¹ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
¹² Department of Epidemiology and Biostatistics, School of Public Health, Chengdu Medical College, Chengdu, Sichuan, China. Electronic address: 21376686@qq.com.
¹³ Section of Epidemiology and Population Health, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, China. Electronic address: pxiongfei@scu.edu.cn.

PMID: 38755082
DOI: 10.1016/j.numecd.2024.03.031

Abstract

Background and aims: Our study examined the trends of cardiovascular health metrics in individuals with coronary heart disease (CHD) and their associations with all-cause and cardiovascular disease mortality in the US.

Methods and results: The cohort study was conducted based on the National Health and Nutrition Examination Survey 1999-2018 and their linked mortality files (through 2019). Baseline CHD was defined as a composite of self-reported doctor-diagnosed coronary heart disease, myocardial infarction, and angina pectoris. Cardiovascular health metrics were assessed according to the American Heart Association recommendations. Long-term all-cause and cardiovascular disease mortality were the primary outcomes. Survey-adjusted Cox regression models were used to estimate hazard ratios and corresponding 95% confidence intervals for the associations between cardiovascular health metrics and all-cause and cardiovascular disease mortality. The prevalence of one or fewer ideal cardiovascular health metrics increased from 14.15% to 22.79% (P < 0.001) in CHD, while the prevalence of more than four ideal cardiovascular health metrics decreased from 21.65% to 15.70 % (P < 0.001) from 1999 to 2018, respectively. Compared with CHD participants with one or fewer ideal cardiovascular health metrics, those with four or more ideal cardiovascular health metrics had a 35% lower risk (hazard ratio, 0.65; 95% confidence interval: 0.51, 0.82) and a 44% lower risk (0.56; 0.38, 0.84) in all-cause and cardiovascular disease mortality, respectively.

Conclusion: Substantial declines were noted in ideal cardiovascular health metrics in US adults with CHD. A higher number of cardiovascular health metrics was associated with lower all-cause and cardiovascular disease mortality in them.

Keywords: Cardiovascular health metrics; Cohort study; Coronary heart disease; Mortality.

Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.