Abstract 19417: Change in Cardiovascular Health Score Predicts Incident Cardiovascular Disease and Total Mortality

Introduction: The AHA 2020 Strategic Impact Goals target a 20% relative improvement in overall cardiovascular health in all Americans with the use of 4 health behaviors (smoking, body weight, physical activity and diet) and 3 health factors (plasma glucose, plasma cholesterol and blood pressure) metrics. The cardiovascular health score (CHS), which is based on all the 7 ideal health metrics, has been shown to be inversely associated with cardiovascular disease (CVD) risk. However, how the changes in the CHS over time impact risk of CVD and mortality has not been examined in a large population. Methods: Our study included 63,905 Chinese adults (50,081 men and 13,824 women) free of CVD and cancer in 2008. Information on the cardiovascular health metrics in 2006 and 2008 was collected. We calculated the change in CHS (ΔCHS), which was defined as the CHS in 2008 minus the CHS in 2006. We used Cox regression model to calculate HRs and the 95% CIs for risk of CVD and total mortality in 2008-2014, respectively, according to ΔCHS from 2006 to 2008. Results: During median 6 years of follow-up, we identified 1,838 incident CVD events and 2,162 deaths. Improvement in CHS from 2006 to 2008 was associated with lower risk of developing CVD (P-trend = 0.001, Figure 1B). Each unit of improvement in CHS was associated with 13% lower subsequent risk of CVD (adjusted HR=0.87; 95% CI: 0.84-0.91) and 4% lower risk of total mortality (adjusted HR =0.96; 95% CI: 0.94-0.98), respectively, after adjusting for age, sex, educational level, income, occupation, alcohol intake, serum high-sensitivity C-reactive protein concentrations, and CHS in 2006. The associations were not modified by age, sex, baseline CHS, and C-reactive protein concentrations (P-interaction>0.1 for all). Conclusions: Improving the overall cardiovascular health status by optimizing cardiovascular health behaviors and factors was associated with lower incidence of CVD and total mortality.