Nzechukwu M Isiozor1, Setor K Kunutsor2,3, Ari Voutilainen1, Sudhir Kurl1, Jussi Kauhanen1, Jari A Laukkanen1,4,5. 1. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland. 2. National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK. 3. Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, UK. 4. Faculty of Sport and Health Sciences, University of Jyvaskyla, Finland. 5. Central Finland Health Care District, Department of Internal Medicine, Jyvaskyla, Finland.
Abstract
BACKGROUND: Strong associations have been demonstrated between the American Heart Association's cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland. METHODS AND RESULTS: We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0-2 (poor), 3-4 (intermediate) and 5-7 (ideal). Multivariate Cox regression models were used to estimate the hazards ratios (HRs) and 95% confidence intervals (CIs) of ideal CVH metrics for SCD and all-cause mortality. During a median follow-up period of 25.8 years, 280 SCDs and 1289 all-cause mortality events were recorded. The risks of SCD and all-cause mortality decreased continuously with increasing number of CVH metrics across the range 2-7 (p value for non-linearity for all <0.05). In multivariable analyses, men with an ideal CVH score had an 85% reduced risk of SCD compared with men with a poor CVH score (HR 0.15; 95% CI 0.05-0.48; p = 0.001). For all-cause mortality, there was a 67% lower risk among men with an ideal CVH score compared with those with a poor CVH score (HR 0.33; 95% CI 0.23-0.49; p <0.001). CONCLUSIONS: Ideal CVH metrics were strongly and linearly associated with decreased risks of SCD and all-cause mortality among middle-aged men in Finland. Published on behalf of the European Society of Cardiology. All rights reserved.
BACKGROUND: Strong associations have been demonstrated between the American Heart Association's cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland. METHODS AND RESULTS: We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0-2 (poor), 3-4 (intermediate) and 5-7 (ideal). Multivariate Cox regression models were used to estimate the hazards ratios (HRs) and 95% confidence intervals (CIs) of ideal CVH metrics for SCD and all-cause mortality. During a median follow-up period of 25.8 years, 280 SCDs and 1289 all-cause mortality events were recorded. The risks of SCD and all-cause mortality decreased continuously with increasing number of CVH metrics across the range 2-7 (p value for non-linearity for all <0.05). In multivariable analyses, men with an ideal CVH score had an 85% reduced risk of SCD compared with men with a poor CVH score (HR 0.15; 95% CI 0.05-0.48; p = 0.001). For all-cause mortality, there was a 67% lower risk among men with an ideal CVH score compared with those with a poor CVH score (HR 0.33; 95% CI 0.23-0.49; p <0.001). CONCLUSIONS: Ideal CVH metrics were strongly and linearly associated with decreased risks of SCD and all-cause mortality among middle-aged men in Finland. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Gilberto Andrade Tavares; Joathan Borges Ribeiro; Marcos Antonio Almeida-Santos; Antônio Carlos Sobral Sousa; José Augusto Soares Barreto-Filho Journal: Front Cardiovasc Med Date: 2022-08-18