Young adults who improve their poor CV health may reduce future CVD risk
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Young adults with poor CV health who improved their risk factors lowered their future risk for CV events, although not as much as those who always had ideal CV health, according to a research letter published in Circulation.
“Most people lose ideal cardiovascular health before they reach midlife, yet few young people have immediate health concerns and many do not usually seek medical care until approaching midlife. We need strategies to help preserve or restore heart health in this population because we know poor heart health in young adults is linked to premature cardiovascular disease,” Hyeon Chang Kim, MD, PhD, a professor in the department of preventive medicine at Yonsei University College of Medicine in Seoul, South Korea, said in a press release.
Researchers analyzed data from the Korean National Health Insurance Service collected from routine health examinees aged 20 to 39 years from 2003 to 2004.
The primary outcome was CVD, defined as CV death or first hospitalization for MI, stroke or HF by Dec. 31, 2019.
The study included 3,565,189 participants (median age, 31 years; 66% men) with baseline CV health scores, excluding examinees with incomplete information or prior CVD. Each participant received a CV health score of 0 to 6, one point for each of six nondietary ideal CV health factors, modified from the American Heart Association’s Life’s Simple 7.
According to the researchers, although people who improved their CV health score over time reduced their risk for CVD, those who started with and kept a higher CV health score eventually had the smallest chance of CVD during the study period.
The rate of premature (younger than 55 years) CVD was 0.23% per year in patients with a CV health score of 0, highest of any score, according to the researchers.
Among individuals with a CV health score of 6, the incidence rate of premature CVD was less than 0.02% per year. Compared with those with a score of 0, premature CVD risk was reduced by the following: 26% for a score of 1, 49% for a score of 2, 65% for a score of 3, 75% for a score of 4, 82% for a score of 5 and 85% for a score of 6, the researchers wrote.
Each one-point increase in CV health reduced risk for MI by 42%, HF by 30%, CV death by 25% and stroke by 24%, the researchers wrote.
In a subgroup of 2,881,115 participants who had health examinations in 2003-2004 and 2005-2008, an increase in CV health score from baseline to follow-up examination was associated with reduced risk for CVD (HR = 0.79; 95% CI, 0.78–0.8) per one-point improvement in CV health score, according to the researchers.
Yet, irrespective of improved CV health score at follow-up, participants who had low baseline CV health scores were at a greater hazard for CVD than those who maintained high CV health scores at both baseline and follow-up, according to the researchers.
“Notwithstanding, the evidenced strong associations of early-life CV health and its change with premature CVD events highlight the pressing need for timely (and repeated) monitoring of CV health and primordial prevention of CV health declines through young adulthood and beyond,” the researchers wrote.
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