Just 1.2% of Americans met all 7 cardiovascular health metrics from 2005 to 2010, compared to 2% from 1988 to 1994, researchers reported this week in JAMA (Journal of the American Medical Association). Although some factors have improved, such as smoking rates, others have not, the authors explained.

The study, said to include a nationally representative population sample, found that among nearly 44,959 adults who met at least seven of the recommended American Heart Association’s cardiovascular health behaviors, their risk of death was considerably lower compared to those who met fewer behaviors.

The authors added that a very small percentage of US adults regularly meet all seven factors.

As background information, the researchers wrote:

“Cardiovascular disease (CVD) is the leading cause of deaths in the United States [greater than 800,000, or about 1 in 3 overall deaths/year], with estimated annual direct and overall costs of $273 billion and $444 billion, respectively,”

The AHA (American Heart Association) recently announced seven recommendations for improving heart/cardiovascular health, which would result in lower cardiovascular-related deaths.

The recommended behaviors (cardiovascular health metrics) include:

  • Not smoking
  • Physical activity (being active)
  • Having blood pressure under control
  • Maintaining healthy blood glucose levels
  • Maintaining healthy blood cholesterol levels
  • Maintaining a healthy body weight
  • Following a healthy and balanced diet

Quanhe Yang, Ph.D., from the CDC (Centers for Disease Control and Prevention) and team set out to determine what the trends of these health metrics were in the USA, and how they might impact on all-cause and CVD (cardiovascular disease) mortality. They studied data from NHANES (National Health and Nutrition Examination Survey), which included 44,959 people aged 20+ years. Several periods were examined, ranging from 1988 to the end of 2006.

Below are some data from their findings (1988 to 2006):

  • Smoking rates have dropped continuously
  • Blood pressure levels have not improved
  • Blood cholesterol levels have not improved
  • The number of people achieving desirable BMIs (body mass indexes) has fallen
  • Fewer people have achieved desirable levels of fasting glucose
  • 2% of people met all 7 cardiovascular health metrics in 1988-1994, compared to 1.2% in 2005-2010

The following groups of people were found to have met a greater number of cardiovascular health metrics: individuals with higher academic levels, non-Hispanic Caucasians, females, and younger adults of both sexes.

The authors wrote:

“During a median [midpoint] of 14.5 years of follow-up in the NHANES III Linked Mortality File cohort, participants who met 6 or more vs. 1 or fewer cardiovascular health metrics had a 51 percent lower risk of all-cause mortality, a 76 percent lower risk of CVD mortality, and a 70 percent lower risk of IHD mortality. In addition, meeting a greater number of cardiovascular health metrics also appeared to be associated with lower risk for all-cancer mortality.”

According to their analysis, younger participants have a proportionally much lower long-term risk of premature CVD death if they meet all cardiovascular health metrics.

The researchers added:

“In summary, our findings indicate that the presence of a greater number of cardiovascular health metrics was associated with a graded and significantly lower risk of total and CVD mortality.

Healthy People 2020 and the AHA’s national strategy to reduce CVD morbidity and mortality by 20 percent by 2020 through promoting ideal cardiovascular health metrics represents a great challenge but also an achievable goal.

Coordinated efforts, such as the recently announced Million Hearts initiative, align CVD prevention and control activities across the public and private sectors, creating opportunities to reduce the burden of CVD across a large segment of the population.”

Donald M. Lloyd-Jones, M.D., Sc.M., from the Northwestern University Feinberg School of Medicine, Chicago, wrote in an accompanying editorial in the same issue of JAMA:

“Despite the apparent difficulties in achieving the goal, there is much to be optimistic about, and opportunities abound for physicians, policy makers, and consumers to support improvements in cardiovascular health.

Continued focus through the health care system on meeting primary and secondary prevention targets is critically important, so that individuals at risk can take one step forward from poor to intermediate cardiovascular health.

Advocacy will be needed for new public health and social policies to tilt the playing field toward healthier choices, so more individuals can move from intermediate to ideal levels or maintain ideal cardiovascular health.

The debate over this year’s farm bill, which will set policy for years to come, represents an opportunity for advocacy for cardiovascular health and a healthier food supply for all. Efforts to reduce sodium in the food supply are ongoing on multiple fronts.”

Written by Christian Nordqvist