Pet Ownership and Cardiovascular Risk: A Scientific Statement From the American Heart Association

Abstract

C ardiovascular disease (CVD) is the leading cause of death in the United States. 1 Despite efforts promoting primary and secondary CVD prevention, [2][3][4][5][6][7][8] obesity and physical inactivity remain at epidemic proportions, with >60% of Americans adults overweight or obese and >50% not performing recommended levels of physical activity.9 Similarly, hypertension, hypercholesterolemia, and other CVD risk factors remain poorly controlled in many Americans.Despite numerous pharmacological and device-based advances in the management of patients with established CVD, morbidity and mortality associated with this condition remain substantial.Hence, a critical need exists for novel strategies and interventions that can potentially reduce the risk of CVD and its attendant morbidity and mortality.Numerous studies have explored the relationship between pet (primarily dog or cat) ownership and CVD, with many reporting beneficial effects, including increased physical activity, favorable lipid profiles, lower systemic blood pressure, improved autonomic tone, diminished sympathetic responses to stress, and improved survival after an acute coronary syndrome.Accordingly, the potential cardiovascular benefits of pet ownership have received considerable lay press and medical media coverage and attention from the Centers for Disease Control and Prevention 10 and have been the focus of a meeting sponsored by the National Institutes of Health.11 The purpose of this American Heart Association Scientific Statement is to critically assess the data regarding the influence of pet ownership on the presence and reduction of CVD risk factors and CVD risk. Pet Ownership and Systemic HypertensionSome, but not all, studies of pet ownership and systemic blood pressure have found an association between pet ownership and lower blood pressure.An Australian study of 5741 participants attending a free screening clinic found that pet owners had significantly (P=0.03)lower systolic blood pressures than pet nonowners despite similar body mass index (BMI) and socioeconomic profiles.12 In a study of 240 married couples with or without pets, both systolic and diastolic blood pressures were significantly (P<0.01)lower in participants with a pet (dog or cat) than in those without a pet (Allen et al 13 and personal communication from Karen Allen on P values, August 12, 2012).An online electronic survey of dog owners (n=536) and nonowners (n=380) found a greater adjusted odds ratio (OR) of self-reported hypertension in nonowners (OR, 1.71; 95% confidence interval [CI], 1.03-2.83).14 A study of 1179 subjects found that pet owners had lower systolic blood pressure (132.8 versus 139.5 mm Hg), pulse pressure (55.5 versus 63.9 mm Hg), and mean arterial pressure (105.0 versus 107.6 mm Hg) than nonowners and a lower incidence of hypertension (OR, 0.62; 95% CI, 0.49-0.80);however, after adjustment for age and other confounders, pet ownership was no longer associated with a lower blood pressure or incidence of hypertension.15 A community survey of 5079 middle-aged adults found pet