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Ideal Cardiovascular Health and Mortality From All Causes and Diseases of the Circulatory System Among Adults in the United States
Open accessAbstract
Background—: Recently, the American Heart Association developed a set of 7 ideal health metrics that will be used to measure progress toward their 2020 goals for cardiovascular health. The objective of the present study was to examine how well these metrics predicted mortality from all causes and diseases of the circulatory system in a national sample of adults in the United States. Methods and Results—: We used data from 7622 adults ≥20 years of age who participated in the National Health and Nutrition Examination Survey from 1999 to 2002 and whose mortality through 2006 was determined via linkage to the National Death Index. For the dietary and glycemic metrics, we used alternative measures. During a median follow-up of 5.8 years, 532 deaths (186 deaths resulting from diseases of the circulatory system) occurred. About 1.5% of participants met none of the 7 ideal cardiovascular health metrics, and 1.1% of participants met all 7 metrics. The number of ideal metrics was significantly and inversely related to mortality from all causes and diseases of the circulatory system. Compared with participants who met none of the ideal metrics, those meeting ≥5 metrics had a reduction of 78% (adjusted hazard ratio, 0.22; 95% confidence interval, 0.10–0.50) in the risk for all-cause mortality and 88% (adjusted hazard ratio, 0.12; 95% confidence interval, 0.03–0.57) in the risk for mortality from diseases of the circulatory system. Conclusion—: The number of ideal cardiovascular health metrics is a strong predictor of mortality from all causes and diseases of the circulatory system.
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“However, the prevalence of ideal cardiovascular health is very low in the US population, and the prevalence of poor-quality diet, physical inactivity, and overweight/obesity is alarmingly high, presaging a worsening of the current distribution of health biomarkers.1–8”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Conjoint use of high-risk and population strategies is essential to optimize cardiovascular outcomes and healthcare costs.5,32–34”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [5]
Experimental — accuracy not yet measuredIn the citing paper
“Current smokers have a 2 to 4 times increased risk of stroke compared with nonsmokers or those who have quit for >10 years.13,14”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“Most adults in Asian subgroups were in the healthy weight range, with rates ranging from 51% for Filipino adults to 68% for Chinese adults.”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“Filipino adults (14%) were more than twice as likely to be obese (BMI ≥30 kg/m2) as Asian Indian (6%), Vietnamese (5%), or Chinese (4%) adults.13”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“Variation at the 9p21.3 region also increases the risk of HF13 and sudden death.14”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“The age-adjusted prevalence of high LDL cholesterol in US adults was 26.6% in 1988 to 1994 and 25.3% in 1999 to 2004 (NHANES/NCHS).”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“On the basis of 2010 BRFSS (CDC) data, the prevalence of adults in the United States who reported ever having been told by a physician that they had DM ranged from 5.3% in Alaska to 13.2% in Alabama. The median percentage among all states was 8.7%.13”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“In 1988 to 1994, two thirds of all adolescents had at least 1 metabolic abnormality.13”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“Furthermore, urine albumin level is associated with progression to CKD across all levels of reduced eGFR.13”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“Awareness was 66% lower among black and Hispanic women than among white women,13”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“Awareness of heart attack signs was low for all racial/ethnic and age groups surveyed.13”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“and the racial/ethnic difference has not changed appreciably over time.”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [13]
In the citing paper
“However, the prevalence of ideal cardiovascular health is very low in the US population, and the prevalence of poor-quality diet, physical inactivity, and overweight/obesity is alarmingly high, presaging a worsening of the current distribution of health biomarkers.1–8”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [5]
In the citing paper
“Ford and colleagues5 observed that adults who had ≥5 of the 7 metrics at ideal levels, compared with 0 metrics, were at 78% lower risk for all-cause mortality and 88% lower risk for cardiovascular disease mortality over 5.8 years of follow-up.”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [5]
In the citing paper
“However, the prevalence of ideal cardiovascular health is very low in the US population, and the prevalence of poor-quality diet, physical inactivity, and overweight/obesity is alarmingly high, presaging a worsening of the current distribution of health biomarkers.1–8”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [5]
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Metadata
- Authors
- Ford, E. S., Greenlund, K. J., & Hong, Y.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Venue
- Circulation
- Published
- 2012-02-28
- Volume
- 125
- Issue
- 8
- Pages
- 987-995
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4556343
- OpenAlex
- W2100590447
- Cited by
- 378
- References
- 31
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 35 · 2023: 24 · 2022: 25 · 2021: 30 · 2020: 24 · 2019: 22 · 2018: 29 · 2017: 28 · 2016: 34 · 2015: 41 · 2014: 27 · 2013: 26 · 2012: 15
- FWCI
- 22.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- cardiovascular health, all-cause mortality, circulatory diseases, mortality prediction, glycemic metrics, cardiovascular disease prevention
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Cause of Death, Female, Follow-Up Studies, Health Status Indicators, Humans, Male, Middle Aged, Nutrition Surveys, Risk Factors, United States, Cohort Studies
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