Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults

<p><strong>Background:</strong> Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.</p>...

Full description

Bibliographic Details
Main Authors: Zhang, Y, Yu, C, Chen, S, Tu, Z, Zheng, M, Lv, J, Wang, G, Liu, Y, Yu, J, Guo, Y, Yang, L, Chen, Y, Guo, K, Yang, K, Yang, H, Zhou, Y, Jiang, Y, Zhang, X, He, M, Liu, G, Chen, Z, Wu, T, Wu, S, Li, L, Pan, A
Format: Journal article
Language:English
Published: Wolters Kluwer 2023
_version_ 1797110064544219136
author Zhang, Y
Yu, C
Chen, S
Tu, Z
Zheng, M
Lv, J
Wang, G
Liu, Y
Yu, J
Guo, Y
Yang, L
Chen, Y
Guo, K
Yang, K
Yang, H
Zhou, Y
Jiang, Y
Zhang, X
He, M
Liu, G
Chen, Z
Wu, T
Wu, S
Li, L
Pan, A
author_facet Zhang, Y
Yu, C
Chen, S
Tu, Z
Zheng, M
Lv, J
Wang, G
Liu, Y
Yu, J
Guo, Y
Yang, L
Chen, Y
Guo, K
Yang, K
Yang, H
Zhou, Y
Jiang, Y
Zhang, X
He, M
Liu, G
Chen, Z
Wu, T
Wu, S
Li, L
Pan, A
author_sort Zhang, Y
collection OXFORD
description <p><strong>Background:</strong> Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.</p> <p><strong>Methods:</strong> A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004–2018), Dongfeng-Tongji cohort (2008–2018), and Kailuan study (2006–2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.</p> <p><strong>Results:</strong> During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10–14 vs. 0–6 were 0.52 (0.41–0.67), 0.44 (0.37–0.53), 0.54 (0.45–0.66), and 0.86 (0.64–1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.</p> <p><strong>Conclusions:</strong> ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.</p>
first_indexed 2024-03-07T07:50:01Z
format Journal article
id oxford-uuid:75fcf3c1-d8ff-490e-b6d2-2b95e0c9c01b
institution University of Oxford
language English
last_indexed 2024-03-07T07:50:01Z
publishDate 2023
publisher Wolters Kluwer
record_format dspace
spelling oxford-uuid:75fcf3c1-d8ff-490e-b6d2-2b95e0c9c01b2023-07-11T08:24:31ZIdeal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adultsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:75fcf3c1-d8ff-490e-b6d2-2b95e0c9c01bEnglishSymplectic ElementsWolters Kluwer2023Zhang, YYu, CChen, STu, ZZheng, MLv, JWang, GLiu, YYu, JGuo, YYang, LChen, YGuo, KYang, KYang, HZhou, YJiang, YZhang, XHe, MLiu, GChen, ZWu, TWu, SLi, LPan, A<p><strong>Background:</strong> Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.</p> <p><strong>Methods:</strong> A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004–2018), Dongfeng-Tongji cohort (2008–2018), and Kailuan study (2006–2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.</p> <p><strong>Results:</strong> During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10–14 vs. 0–6 were 0.52 (0.41–0.67), 0.44 (0.37–0.53), 0.54 (0.45–0.66), and 0.86 (0.64–1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.</p> <p><strong>Conclusions:</strong> ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.</p>
spellingShingle Zhang, Y
Yu, C
Chen, S
Tu, Z
Zheng, M
Lv, J
Wang, G
Liu, Y
Yu, J
Guo, Y
Yang, L
Chen, Y
Guo, K
Yang, K
Yang, H
Zhou, Y
Jiang, Y
Zhang, X
He, M
Liu, G
Chen, Z
Wu, T
Wu, S
Li, L
Pan, A
Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
title Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
title_full Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
title_fullStr Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
title_full_unstemmed Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
title_short Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
title_sort ideal cardiovascular health and mortality pooled results of three prospective cohorts in chinese adults
work_keys_str_mv AT zhangy idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT yuc idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT chens idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT tuz idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT zhengm idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT lvj idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT wangg idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT liuy idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT yuj idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT guoy idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT yangl idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT cheny idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT guok idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT yangk idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT yangh idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT zhouy idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT jiangy idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT zhangx idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT hem idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT liug idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT chenz idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT wut idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT wus idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT lil idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults
AT pana idealcardiovascularhealthandmortalitypooledresultsofthreeprospectivecohortsinchineseadults