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April 01, 2021
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Higher CV health scores tied to lower risk for major CVD events

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If all U.S. adults attained high CV health status, 2 million adult CVD events could be prevented annually, according to a study published in the Journal of the American Heart Association.

“The potential benefits of achieving high CV health in all U.S. adults are considerable, and even a partial improvement in CV health scores would be highly beneficial,” the researchers wrote.

Graphical depiction of data presented in article
If all U.S. adults attained high CV health status, 2 million adult CVD events could be prevented annually. Data were derived from Bundy JD, et al. J Am Heart Assoc. 2021;doi:10.1161/JAHA.120.019681.

The researchers estimated the prevalence of low, moderate and high CV health in U.S. adults based on 11,696 participants from the National Health and Nutrition Examination Survey and estimated annual incidence rates of major CVD events in U.S. adults with low, moderate or high CV health based on 30,447 participants from seven U.S. community-based cohort studies. The researchers then used those data to estimate population-attributable fractions of CVD and how many CV events could be prevented each year if all U.S. adults had high CV health.

According to the researchers, 7.3% (95% CI, 6.3-8.3) of U.S. adults had high CV health, 34.2% (95% CI, 32.4-36) had moderate CV health and 58.5% (95% CI, 56.1-60.9) had low CV health.

“The prevalence of high CV health was greater among younger compared with older adults, women compared with men, and white/other (including Mexican American, other Hispanic, non-Hispanic Asian and other races) compared with Black adults,” the researchers wrote.

In the analysis, 70% (95% CI, 56.5-79.9) of CVD events could be attributed to low and moderate levels of CV health. If all U.S. adults attained a high CV health score, 2 million (95% CI, 1,600,000-2,300,000) CVD events could be prevented annually, the researchers wrote.

According to researchers, 42% (95% CI, 35.3-48.2) of all CVD events could be attributed to low levels of CV health alone, and 1.2 million (95% CI, 1,000,000-1,400,000) CVD events could be prevented annually if all U.S. adults with low CV health attained moderate CV health.

“Population attributable fraction for CVD events were higher among younger compared with older adults, women compared with men, and Black compared with white/other (including Mexican American, other Hispanic, non-Hispanic Asian and other races) adults,” the researchers wrote.

According to a related editorial, population-attributable fraction is an important population-level statistic that can help guide future policy.

Erin D. Michos
Sadiya S. Khan

“Population-attributable fractions were higher among younger adults than older adults. This emphasizes the critical need to improve CV health earlier in the life span. Well-being needs to start early in life. Adverse childhood experiences influence CVD risk in adulthood,” wrote Cardiology Today Editorial Board Member Erin D. Michos, MD, MHS, FACC, FAHA, FASE, director of Women’s Cardiovascular Health and associate director of preventive cardiology at the Ciccarone Center for the Prevention of Cardiovascular Disease at Johns Hopkins School of Medicine, and Sadiya S. Khan, MD, MSc, assistant professor of medicine (cardiology) and preventive medicine (epidemiology) at Northwestern University Feinberg School of Medicine.

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