Cardiovascular Health Poor in the United States

The community-based Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study attempted to examine cardiovascular health in terms of differences in gender and race. More than 1,000 subjects participated in the study. Out of these, only one met all the seven ideal goals of cardiovascular health (according to American Heart Association’s definition), less than 10 percent met five goals, 2 percent met four components in the health criteria and 1.4 percent met three. Another interesting note was that Caucasians fared better than African-Americans. However, the overall values of cardiovascular health across all races were poor and needs attention.

The American Heart Association (AHA) set objectives for the year 2020 called Impact goals; one critical parameters was “cardiovascular disease.” The guidelines state that focus on overall health improvement and risk reduction for cardiovascular disease and stroke is essential for ideal cardiac health. Ideal cardiovascular health is quantified by four health behaviors comprising body mass index (BMI) being less than 25 kg/m2, physical activity, diet patterns and not smoking, as well as three health factors including untreated levels of cholesterol being less then 200 mg/dL, untreated blood pressure at 120/80mm Hg, and untreated fasting glucose at 100 mg/dL. The application of these goals was studied in 1,933 participants, as part of the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study.

* Baseline information on race, age, gender, educational background and income was collected from 1,933 participants.
* Prior events and family history of cardiovascular disease, smoking, hypertension, diabetes, disorders in lipid metabolism, exercise patterns and nutrition were noted to identify risk levels.
* The defined AHA parameters of four health behaviors, including smoking, BMI, exercise frequency and modules, balanced diet and three clinical parameters, i.e., total cholesterol, fasting plasma glucose and blood pressure, were marked on a scale.
* These scores were statistically analyzed.

* Among the 1,933 participants, only one person met all the seven ideal cardiovascular parameters defined by AHA. Most people met three or less than three of the ideal health criteria.
* More women and fewer African-Americans fit into a score equal to or more than five. Except for total cholesterol, African-Americans fared poorer in all cardiac health parameters.
* Older people recorded poorer cardiac health scores.
* The ratings for smoking, blood pressure, fasting glucose and BMI were higher for men, and physical activity and cholesterol control was poorer for women. These results showed up even though they consumed the ideal amount of fruits and vegetables.

Recruitment for this study was based on a set parameter, for recruiting healthy volunteers who had low smoking values and a higher education level.  Secondly, blood pressure was recorded at a single visit only. Lastly, measures of diet and exercise patterns were approximated.  Future studies based on the AHA score may show that the prevalence of ideal dietary categories may be much lower than what has been noted in this study.

This study evaluated the risk factors involved in poor cardiovascular health. Interestingly, the findings reflected the poor standards of cardiovascular health in the middle-aged population. This research also revealed the impact of race on health. For example, African-Americans registered low scores, compared to other races. The new refined AHA goals ensure identification of risk, and addressing and improving overall cardiac health. Bridging the distance between ideal cardiac health and the current state of heart heath as put forth by guidelines from the AHA for 2020 will be challenging based on data from this current study. Consistent efforts at numerous stages will definitely aid in attaining the prescribed goals.

For More Information:
Low Prevalence of “Ideal Cardiovascular Health” in a Community-Based Population: The Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) Study
Publication Journal: Circulation, 2011
By Claudia Bambs, MD; Kevin E. Kip, PhD; School of Medicine, Pontificia Universidad Cato´lica de Chile, Santiago, Chile and College of Nursing, University of South Florida, Tampa, Florida

*FYI Living Lab Reports Are Summaries of the Original Research.

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