The Ideal Cardiovascular Health Metrics Associated Inversely With Mortality From All Causes And From Cardiovascular Diseases Among Adults In A Northern Chinese Industrial City

Objectives The American Heart Association has recently established seven idealcardiovascular health metrics for cardiovascular health promotion and disease reduction(i.e., non-smoking, normal body mass index, physically active, healthy diet, and normallevels of cholesterol, blood pressure and fasting blood glucose). The present study seeks toevaluate how well these metrics predict mortality from all causes and cardiovasculardiseases in adult Chinese living in a northern industrial city.Methods Prospective cohort study method was used in this study. Data of95,429adults(including76,109males and19,320females) who participated in the Kailuan cohortstudy from June2006to October2007was analyzed. The age ranged from18to98(median51.5±12.5). All participants underwent questionnaire assessment, clinicalexamination, laboratory assessments and were followed up every two years. All workerswere observed the occurrence of death. According to the American Heart Association(AHA) definition of ideal cardiovascular health behavior and factors, Cox proportionalhazards regression was used to calculate hazard ratios and95%confidence intervals forcardiovascular health behavior and factors.Results During a median follow-up of4.02years,1,843deaths occurred, with597deaths resulting from cardiovascular diseases. Only9.0%of the study cohort had5～7ideal cardiovascular health behaviors and factors. Only0.1%of study cohort (93cases)had all the ideal cardiovascular health behaviors and factors.69.8%of the study cohorthad less than four ideal cardiovascular health behaviors and factors. Lower mortalityrates from all causes and cardiovascular diseases were observed among the subjects whomet a higher number of the ideal health metrics. Compared to the participants who metnone or one ideal health metric, those meeting≥5ideal health metrics had a lower riskof all-cause mortality by30%(adjusted hazard ratio,0.70;95%confidence interval,0.56～0.88) and a lower risk of mortality from cardiovascular diseases by39%(adjustedhazard ratio,0.61;95%confidence interval,0.41～0.89). Four metrics (smoking status,physical activity, blood pressure and fasting blood glucose) were significantly associatedwith all-cause mortality. Three metrics (physical activity, blood pressure and fastingblood glucose) were significantly associated with mortality from cardiovascular diseases.Conclusion The number of ideal health metrics is negatively associated with mortality rates from all causes and cardiovascular diseases among adults in a Northern Chineseindustrial city. The data supports the AHA recommendation of ideal health metrics foradults from Northern China.