Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease

Background The Healthy Aging Index (HAI) has been regarded as useful in capturing the health status of multiple organ systems. However, to what extent the HAI is associated with major cardiovascular events remains largely unknown. The authors constructed a modified HAI (mHAI) to quantify the associa...

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Main Authors: Ninghao Huang, Zhenhuang Zhuang, Zimin Song, Wenxiu Wang, Yueying Li, Yimin Zhao, Wendi Xiao, Xue Dong, Jinzhu Jia, Zhonghua Liu, Caren E. Smith, Tao Huang
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.122.026736
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author Ninghao Huang
Zhenhuang Zhuang
Zimin Song
Wenxiu Wang
Yueying Li
Yimin Zhao
Wendi Xiao
Xue Dong
Jinzhu Jia
Zhonghua Liu
Caren E. Smith
Tao Huang
author_facet Ninghao Huang
Zhenhuang Zhuang
Zimin Song
Wenxiu Wang
Yueying Li
Yimin Zhao
Wendi Xiao
Xue Dong
Jinzhu Jia
Zhonghua Liu
Caren E. Smith
Tao Huang
author_sort Ninghao Huang
collection DOAJ
description Background The Healthy Aging Index (HAI) has been regarded as useful in capturing the health status of multiple organ systems. However, to what extent the HAI is associated with major cardiovascular events remains largely unknown. The authors constructed a modified HAI (mHAI) to quantify the association of physiological aging with major vascular events and explored how the effects of a healthy lifestyle can modify this association. Methods and Results The participants with either missing values of any individual mHAI component or major illnesses such as heart attack, angina and stroke, and self‐reported cancer at baseline were excluded. The mHAI components include systolic blood pressure, reaction time, forced vital capacity, serum cystatin c, and serum glucose. The authors used Cox proportional hazard models to quantify the association of mHAI with major adverse cardiac events, major coronary events, and ischemic heart disease. Cumulative incidence at 5 and 10 years was estimated, and joint analyses were stratified by age group and 4 mHAI categories. The mHAI was significantly correlated with major cardiovascular events, which is a better reflection of the aging level of the body than chronological age. An mHAI was calculated in 338 044 participants aged 38 to 73 years in the UK Biobank. Each point increase in the mHAI was associated with a 44% higher risk of major adverse cardiac events (adjusted hazard ratio [aHR], 1.44 [95% CI, 1.40–1.49]), 44% higher risk of major coronary events (aHR, 1.44 [95% CI, 1.40–1.48]), and 36% higher risk of ischemic heart disease (aHR, 1.36 [95% CI, 1.33–1.39]). The percentage of population‐attribution risk was 51% (95% CI, 47–55) for major adverse cardiac events, 49% (95% CI, 45–53) for major coronary events, and 47% (95% CI, 44–50) for ischemic heart disease, which means that a substantial portion of these events could be prevented. Systolic blood pressure was the factor most significantly associated with major adverse cardiac events (aHR, 1.94 [95% CI, 1.82–2.08]; percentage of population‐attribution risk, 36%), major coronary events (aHR, 2.01 [95% CI, 1.85–2.17]; percentage of population‐attribution risk, 38%), and ischemic heart disease (aHR, 1.80 [95% CI, 1.71–1.89]; percentage of population‐attribution risk, 32%). A healthy lifestyle significantly attenuated mHAI associations with incidence of vascular events. Conclusions Our findings indicate that higher mHAI is associated with increased major vascular events. A healthy lifestyle may attenuate these associations.
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spelling doaj.art-6be971812e744bd88c11f71e88e506b22024-02-29T10:25:12ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-03-0112510.1161/JAHA.122.026736Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart DiseaseNinghao Huang0Zhenhuang Zhuang1Zimin Song2Wenxiu Wang3Yueying Li4Yimin Zhao5Wendi Xiao6Xue Dong7Jinzhu Jia8Zhonghua Liu9Caren E. Smith10Tao Huang11Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Biostatistics, School of Public Health Peking University Beijing ChinaDepartment of Biostatistics Columbia University NY New YorkNutrition and Genomics Laboratory JM‐USDA Human Nutrition Research Center on Aging at Tufts University Boston MADepartment of Epidemiology and Biostatistics, School of Public Health Peking University Beijing ChinaBackground The Healthy Aging Index (HAI) has been regarded as useful in capturing the health status of multiple organ systems. However, to what extent the HAI is associated with major cardiovascular events remains largely unknown. The authors constructed a modified HAI (mHAI) to quantify the association of physiological aging with major vascular events and explored how the effects of a healthy lifestyle can modify this association. Methods and Results The participants with either missing values of any individual mHAI component or major illnesses such as heart attack, angina and stroke, and self‐reported cancer at baseline were excluded. The mHAI components include systolic blood pressure, reaction time, forced vital capacity, serum cystatin c, and serum glucose. The authors used Cox proportional hazard models to quantify the association of mHAI with major adverse cardiac events, major coronary events, and ischemic heart disease. Cumulative incidence at 5 and 10 years was estimated, and joint analyses were stratified by age group and 4 mHAI categories. The mHAI was significantly correlated with major cardiovascular events, which is a better reflection of the aging level of the body than chronological age. An mHAI was calculated in 338 044 participants aged 38 to 73 years in the UK Biobank. Each point increase in the mHAI was associated with a 44% higher risk of major adverse cardiac events (adjusted hazard ratio [aHR], 1.44 [95% CI, 1.40–1.49]), 44% higher risk of major coronary events (aHR, 1.44 [95% CI, 1.40–1.48]), and 36% higher risk of ischemic heart disease (aHR, 1.36 [95% CI, 1.33–1.39]). The percentage of population‐attribution risk was 51% (95% CI, 47–55) for major adverse cardiac events, 49% (95% CI, 45–53) for major coronary events, and 47% (95% CI, 44–50) for ischemic heart disease, which means that a substantial portion of these events could be prevented. Systolic blood pressure was the factor most significantly associated with major adverse cardiac events (aHR, 1.94 [95% CI, 1.82–2.08]; percentage of population‐attribution risk, 36%), major coronary events (aHR, 2.01 [95% CI, 1.85–2.17]; percentage of population‐attribution risk, 38%), and ischemic heart disease (aHR, 1.80 [95% CI, 1.71–1.89]; percentage of population‐attribution risk, 32%). A healthy lifestyle significantly attenuated mHAI associations with incidence of vascular events. Conclusions Our findings indicate that higher mHAI is associated with increased major vascular events. A healthy lifestyle may attenuate these associations.https://www.ahajournals.org/doi/10.1161/JAHA.122.026736biomarkerscardiovascular diseasehealthy aging index
spellingShingle Ninghao Huang
Zhenhuang Zhuang
Zimin Song
Wenxiu Wang
Yueying Li
Yimin Zhao
Wendi Xiao
Xue Dong
Jinzhu Jia
Zhonghua Liu
Caren E. Smith
Tao Huang
Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
biomarkers
cardiovascular disease
healthy aging index
title Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease
title_full Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease
title_fullStr Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease
title_full_unstemmed Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease
title_short Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease
title_sort associations of modified healthy aging index with major adverse cardiac events major coronary events and ischemic heart disease
topic biomarkers
cardiovascular disease
healthy aging index
url https://www.ahajournals.org/doi/10.1161/JAHA.122.026736
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