Cardiovascular health in a southern Mediterranean European country: a nationwide population-based study.

BACKGROUND: There are no published data on cardiovascular health from a national representative sample in a European country. METHODS AND
RESULTS: Data were taken from a cross-sectional study among 11 408 persons representative of the Spanish population ≥18 years of age during 2008 to 2010. Information was collected at participants' homes through structured questionnaires, physical examination, and fasting blood samples, which were centrally analyzed. The American Heart Association has defined ideal cardiovascular health as the simultaneous presence of 4 health behaviors (nonsmoking, body mass index <25 kg/m(2), physical activity at goal, and diet consistent with current recommendations) and 4 health factors (nonsmoking, untreated total cholesterol <200 mg/dL, untreated blood pressure <120/80 mm Hg, and untreated fasting glucose <100 mg/dL) in the absence of clinical cardiovascular disease and diabetes mellitus. Only 0.2% of subjects attained ideal values for all 7 cardiovascular disease health metrics and 3.4% and 15.3% for at least 6 and 5 metrics, respectively. The percentage of subjects who achieved the 4 ideal lifestyles was lower than that for the 4 ideal health factors (0.7% versus 8.1%). Lack of ideal diet was the most frequent health metrics (88.9%). In general, ideal levels of cardiovascular disease health metrics were more frequent in younger subjects, women, and those with higher education.
CONCLUSION: Cardiovascular health in Spain is poor, particularly lifestyles. This illustrates the low effectiveness of public health efforts addressing cardiovascular prevention and the need to improve preventive healthcare services. Given that coronary mortality in Spain is low compared with other Western countries, the factors responsible for this situation should be investigated.