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Association between ideal cardiovascular health score trajectories and arterial stiffness: the Kailuan Study

Abstract

Some studies have shown that a higher ideal cardiovascular health score (CVHS) predicts a lower incidence of arterial stiffness. Few studies have used multiple measurements of CVHS to examine the impact of CVHS on arterial stiffness. The current study aimed to identify the long-term patterns in CVHS trajectory and to explore the association between CVHS trajectory and arterial stiffness. The study cohort consisted of 18,854 participants from the Kailuan Study who were followed up for five physical examinations over 8.10 years. Five discrete CVHS trajectories were identified among the participants: low-stable (8.10%), low-moderate (6.84%), moderate-low (23.46%), moderate-stable (39.83%), and elevated-stable (21.77%). After adjustment for confounding factors, generalized linear model analysis showed that CVHS trajectory group correlated negatively with brachial–ankle pulse wave velocity (baPWV). Compared with the low-stable group, the low-moderate group, moderate-low group, moderate-stable group, and elevated-stable group had B values of −41.81, −24.11, −86.79, and −169.54, respectively. We also used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for CVHS trajectory groups and arterial stiffness. In fully adjusted models, ORs were 0.76 (95% CI: 0.62–0.94) for the low-moderate group, 0.80 (95% CI: 0.67–0.97) for the moderate-low group, 0.51 (95% CI: 0.42–0.62) for the moderate-stable group, and 0.23 (95% CI: 0.18–0.29) for the elevated-stable group compared with the low-stable group. The results were consistent across a number of sensitivity analyses. In conclusion, the higher long-term attainment and the improvement of CVHS were negatively associated with baPWV and could reduce the risk of arterial stiffness. Our study emphasizes the importance of optimizing CVH throughout life to prevent the incidence of arterial stiffness.

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References

  1. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–210.

    Article  Google Scholar 

  2. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. INTERHEART study investigators. effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study):case-control study. Lancet. 2004;364:937–52.

    Article  Google Scholar 

  3. Khanji MY, van Waardhuizen CN, Bicalho VVS, Ferket BS, Hunink MGM, Petersen SE. Lifestyle advice and interventions for cardiovascular risk reduction: a systematic review of guidelines. Int J Cardiol. 2018;263:142–51.

    Article  Google Scholar 

  4. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L. American Heart Association Strategic Planning Task Force and Statistics Committee et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121:586–613.

    Article  Google Scholar 

  5. Huffman MD, Capewell S, Ning H, Shay CM, Ford ES, Lloyd-Jones DM. Cardiovascular health behavior and health factor changes (1988-2008) and projections to 2020:results from the National Health and Nutrition Examination Surveys. Circulation. 2012;125:2595–602.

    Article  Google Scholar 

  6. Wilsgaard T, Loehr LR, Mathiesen EB, Løchen ML, Bønaa KH, Njølstad l, et al. Cardiovascular health and the modifiable burden of incident myocardial infarction: the Tromsø Study. BMC Public Health. 2015;15:221.

    Article  Google Scholar 

  7. Xanthakis V, Enserro DM, Murabito JM, Polak JF, Wollert KC, Januzzi JL, et al. Ideal cardiovascular health: associations with biomarkers and subclinical disease and impact on incidence of cardiovascular disease in the Framingham Offspring Study. Circulation. 2014;130:1676–83.

    Article  CAS  Google Scholar 

  8. Bonet J, Vicente A. Arterial stiffness, organic subclinical damage and cardiovascular risk factor. Med Clin. 2009;133:137–8.

    Article  Google Scholar 

  9. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. European network for non-invasive investigation of large arteries. expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588–605.

    Article  Google Scholar 

  10. Veerasamy M, Ford GA, Neely D, Bagnall A, MacGowan G, Das R, et al. Association of aging, arterial stiffness, and cardiovascular disease: a review. Cardiol Rev. 2014;22:223–32.

    Article  Google Scholar 

  11. Rosenberg AJ, Lane-Cordova AD, Wee SO, White DW, Hilgenkamp TIM, Fernhall B, et al. Healthy aging and carotid performance: strain measures and β-stiffness index. Hypertens Res. 2018;41:748–55.

    Article  Google Scholar 

  12. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension a systematic review. Hypertesion. 2009;54:1328–36.

    Article  CAS  Google Scholar 

  13. Aatola H, Hutri-Kähönen N, Juonala M, Viikari JS, Hulkkonen J, Laitinen T, et al. Lifetime risk factors and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns Study. Hypertension. 2010;55:806–11.

    Article  CAS  Google Scholar 

  14. Im JA, Lee JW, Shim JY, Lee HR, Lee DC. Association between brachial-ankle pulse wave velocity and cardiovascular risk factors in healthy adolescents. J Pediatr. 2007;150:247–51.

    Article  Google Scholar 

  15. Loehr LR, Meyer ML, Poon AK, Selvin E, Palta P, Tanaka H, et al. Prediabetes and diabetes are associated with arterial stiffness in older adults: The ARIC Study. Am J Hypertens. 2016;29:1038–45.

    Article  Google Scholar 

  16. Recio-Rodríguez JI, Rodriguez-Sanchez E, Martin-Cantera C, Martinez-Vizcaino V, Arietaleanizbeaskoa MS, Gonzalez-Viejo N. EVIDENT Investigators group et al. Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness, blood pressure and wave reflections: a randomized controlled trial (EVIDENT II Study). Hypertens Res. 2019;42:852–62.

    Article  Google Scholar 

  17. Aatola H, Hutri-Kahonen N, Juonala M, Laitinen TT, Pahkala K, Mikkilä V, et al. Prospective relationship of change in ideal cardiovascular health status and arterial stiffness: the cardiovascular risk in young finns study. J Am Heart Assoc. 2014;3:e000532.

    Article  Google Scholar 

  18. Spring B, Moller AC, Colangelo LA, Siddique J, Roehrig M, Daviglus ML, et al. Healthy lifestyle change and subclinical atherosclerosis in young adults: coronary artery risk development in young adults (cardia) study. Circulation. 2014;130:10–7.

    Article  Google Scholar 

  19. Shah AM, Claggett B, Folsom AR, Lutsey PL, Ballantyne CM, Heiss G, et al. Ideal cardiovascular health during adult life and cardiovascular structure and function among the elderly. Circulation. 2015;132:1979–89.

    Article  Google Scholar 

  20. Niyonkuru C, Wagner AK, Ozawa H, Amin K, Goyal A, Fabio A. Group-based trajectory analysis applications for prognostic biomarker model development in severe TBI: a practical example. J Neurotramua. 2013;30:938–45.

    Article  Google Scholar 

  21. Nagin DS. Analyzing developmental trajectories: a semiparametric, group based approach. Psychol Methods. 1999;4:139–57.

    Article  Google Scholar 

  22. Zhang Q, Zhou Y, Gao X, Wang C, Zhang S, Wang A, et al. Ideal cardiovascular health metrics and the risks of ischemic and intracerebral hemorrhagic stroke. Stroke. 2013;44:2451–6.

    Article  Google Scholar 

  23. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol. 2009;38:791–813.

    Article  Google Scholar 

  24. Wu SL, Huang ZR, Yang XC, Zhou Y, Wang AX, Chen L, et al. Prevalence of ideal cardiovascular health and Its relationship with the 4-year cardiovascular events in a northern chinese industrial city. Circ Cardiovasc Qual Outcomes. 2012;5:487–93.

    Article  Google Scholar 

  25. Tanaka H, Munakata M, Kawano Y, Ohishi M, Shoji T, Sugawara J, et al. Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness. J Hyoertens. 2009;27:2022–7.

    Article  CAS  Google Scholar 

  26. Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014;63:636–46.

    Article  Google Scholar 

  27. Munakata M, Nunokawa T, Tayama J, Yoshinaga K, Toyota T. Brachial-ankle pulse wave velocity as a novel measure of arterial stiffness: present evidences and perspectives. Curr Hypertens Rev. 2005;1:223–34.

    Article  Google Scholar 

  28. Kawai T, Ohishi M, Onishi M, Ito N, Takeya Y, Maekawa Y, et al. Cut-off value of brachial-ankle pulse wave velocity to predict cardiovascular disease in hypertensive patients: a cohort study. J Atheroscler Thromb. 2013;20:391–400.

    Article  Google Scholar 

  29. Zheng X, Zhang R, Liu X, Zhao H, Liu H, Gao J, et al. Association between cumulative exposure to ideal cardiovascular health and arterial stiffness. Atherosclerosis. 2017;260:56–62.

    Article  CAS  Google Scholar 

  30. Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hieayama Y, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res. 2003;26:615–22.

    Article  Google Scholar 

  31. Crichton GE, Elias MF, Robbins MA. Cardiovascular health and arterial stiffness: the Maine-Syracuse Longitudinal Study. J Hum Hypertens. 2014;28:444–9.

    Article  CAS  Google Scholar 

  32. Ohkuma T, Ninomiya T, Tomiyama H, Kario K, Hoshide S, Kita Y. Collaborative Group for J-BAVEL(Japan Brachial-Ankle Pulsewave Velocity Individual Participant Data Meta-Analysis of Prospective Studies) et al. Brachial-ankle pulse wave velocity and the risk prediction of cardiovascular disease: an individual participant data meta-analysis. Hypertension. 2017;69:1045–52.

    Article  CAS  Google Scholar 

  33. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1318–27.

    Article  Google Scholar 

  34. Yan N, Zhou Y, Wang Y, Wang A, Yang X, Russell A, et al. Association of ideal cardiovascular health and brachial-ankle pulse wave velocity: a cross-sectional study in Northern China. J Stroke Cerebrovasc Dis. 2016;25:41–8.

    Article  Google Scholar 

  35. García-Hermoso A, Martínez-Vizcaíno V, Gomez-Marcos MÁ, Cavero-Redondo I, Recio-Rodriguez JI, García-Ortiz L. Ideal cardiovascular health and arterial stiffness is spanish adults-The EVIDENT Study. J Stroke Cerebrovasc Dis. 2018;27:1386–94.

    Article  Google Scholar 

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Acknowledgements

We thank the staff and participants of the Kailuan study for their important contributions.

Funding

The work for this article was supported by the national natural science foundation of China (81873896) to YY.

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Correspondence to Shouling Wu or Ya Yang.

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Zhang, R., Xie, J., Yang, R. et al. Association between ideal cardiovascular health score trajectories and arterial stiffness: the Kailuan Study. Hypertens Res 43, 140–147 (2020). https://doi.org/10.1038/s41440-019-0341-4

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