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Diabetes has become a global public health problem due to its high incidence, severe complications and prolonged illness. The ideal cardiovascular health behaviors and factors provide a straightforward and simple way to quantify important health behaviors and factors, and clear and operable targets for cardiovascular disease prevention. A growing number of studies confirm that having more ideal cardiovascular health behaviors and factors is also associated with a lower risk of diabetes. This article reviews the relationship between ideal cardiovascular health behaviors and factors and the occurrence and development of diabetes and its complications, and explores the value of ideal cardiovascular health behaviors and factors in the primary, secondary and tertiary prevention of diabetes.
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RESUMEN Introducción: Cinco indicadores de salud cardiovascular: presión arterial, actividad física, índice de masa corporal, consumo de fruta y verdura y fumar tabaco, pueden ser suficientes para predecir el riesgo cardiovascular en individuos sanos a través del índice de Fuster BEWAT. Objetivo: Comparar los resultados de los índices de Fuster BEWAT y el de salud cardiovascular ideal para determinar la salud. Método: Se realizó un estudio descriptivo transversal en el servicio de Atención Primaria del Hospital Manuel Fajardo Rivero de Santa Clara, en el período enero-junio de 2019, se valoró el estado de salud cardiovascular de 347 individuos sanos, sin antecedentes de enfermedad cardiovascular con edades comprendidas entre 40 y 59 años. Se usó el índice de Kappa de Cohen para determinar la concordancia entre el índice de salud cardiovascular ideal y el índice Fuster-BEWAT. Resultados: La escasa actividad física (79,8%), la dieta no balanceada (74,9 %) y la presión arterial no controlada fueron los peores marcadores encontrados. Solo un 15,3% de los hombres y mujeres analizados cumplían con el estado ideal para todos los marcadores del índice de Fuster BEWAT y 17,8% del índice de salud cardiovascular ideal. La concordancia obtenida entre ambos índices, a través del coeficiente Kappa de Cohen (0.935), demostró una relación casi perfecta. Conclusiones: Las puntuaciones de los dos índices mostraron valores similares. El índice Fuster-BEWAT es más sencillo y no requiere resultados analíticos; puede considerarse la primera opción en contextos en los que el acceso a análisis de laboratorio es limitado.
ABSTRACT Introduction: The following five indicators of cardiovascular health: blood pressure, physical activity, body mass index, fruit and vegetable consumption and tobacco smoking, may be sufficient to predict cardiovascular risk in healthy individuals through the Fuster-BEWAT score. Objective: To compare the results of the Fuster-BEWAT score and the ideal cardiovascular health score to determine health. Method: A cross-sectional descriptive study was carried out in the Primary Care Service of the Hospital Manuel Fajardo Rivero in Santa Clara, from January to June 2019, evaluating the cardiovascular health status of 347 healthy individuals without a history of cardiovascular disease, between the ages of 40 and 59 years old. Cohen's kappa coefficient was used to determine the concordance between the ideal cardiovascular health score and the Fuster-BEWAT score. Results: Low physical activity (79.8%), unbalanced diet (74.9%), and uncontrolled blood pressure were the worst markers found. Only 15.3% of the analyzed men and women met the ideal condition for all markers of the Fuster-BEWAT score and 17.8% of the ideal cardiovascular health score. The concordance obtained between both scores, through Cohen's kappa coefficient (0.935), showed an almost perfect relationship. Conclusions: Both scores showed similar values. The Fuster-BEWAT score is simpler and does not require analytical results; it can be considered as a first option in contexts where access to laboratory tests is limited.
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Objectives: To investigate the prevalence of ideal cardiovascular health behaviors and factors, and its association with socioeconomic status (SES) in enterprise employees. Methods: The cluster sampling method was adopted to recruit 27 607 employees aged 18 to 60 years from 45 enterprises across China. The ideal cardiovascular health metrics including behaviors and factors, which were defined according to the AHA criteria, were obtained, and SES was measured by education and occupational class. Multilevel logistic regression models were used to analyze the association between SES and ideal cardiovascular health metrics. Results: Overall, the prevalence of ideal cardiovascular health behavior (smoking, body mass index, salt intake, physical activity) was 51.3%, 67.9%, 14.0%, 31.2%, respectively; prevalence of the ideal cardiovascular factors (fasting blood glucose, total cholesterol, blood pressure) was 72.9%, 81.6%, 27.3%,respectively in this cohort. Among the employees, only 0.6% population met all 7 cardiovascular health metrics. After adjusting the individual and workplace factors, employees with high school (OR=1.18, 95%CI: 1.08-1.29) and college or above education (OR=1.52, 95%CI: 1.37-1.69) were more likely to have ideal cardiovascular health status compared with those with less education; white-collar workers were more likely to have ideal cardiovascular health status compared with blue-collar workers (OR=1.18; 95%CI: 1.08-1.29). Conclusions: The prevalence of ideal cardiovascular health behaviors and factors is low, and is positively associated with SES, suggesting the importance of promoting the cardiovascular health behavior, monitoring/controlling the related cardiovascular factors and reducing the socioeconomic inequalities among Chinese enterprise employees.
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Objective:To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.Methods:The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital.The general information,anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014,respectively.The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated.Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR.Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.Results:After 6 years' follow-up,we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs.(3.2±1.3) items,respectively] (P＜0.05).However,the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2)vs (104.3±24.9) mL/(min.1.73 m2),respectively] (P＜0.01).After adjusting for age,sex,history of hypertension and diabetes,and history of drug usage (antihypertensive,cholesterol-lowering and blood glucose-lowering medication),the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701,P＜0.01).With the improved change in ideal CVH metrics from ≤-2 points,-1 point,0 point,1 point to ≥ 2 points,the magnitude of decline in eGFR was gradually decreased,with significant difference (F=21.71,P＜0.01).Conclusion:The changes in ideal CVH metrics are an independent risk factor for changes of eGFR.Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.
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<p><b>OBJECTIVE</b>Coronary artery calcification (CAC) is a well-established risk predictor of coronary heart disease events and is recognized as an indicator of subclinical atherosclerosis.</p><p><b>METHODS</b>A cross-sectional study consisting of 2999 participants aged ⋝40 years from the Jidong community of Tangshan City, an industrial and modern city of China, was conducted between 2013 and 2014 to examine the association between the ideal cardiovascular health (CVH) metrics and CAC. The ideal CVH metrics were determined based on the definition of the American Heart Association (AHA). The participants were then grouped into 4 categories according to the quartiles of their CVH metric scores as follows: first quartile (0-2), second quartile (3), third quartile (4), and fourth quartile (5-7). CAC was assessed by using high-pitch dual-source CT, and patients were identified based on thresholds of 0, 10, 100, or 400 Agatston units, as per common practice.</p><p><b>RESULTS</b>The prevalence of subclinical atherosclerosis was 15.92%, 13.85%, 6.76%, and 1.93%, determined by using the CAC scores at thresholds of 0, 10, 100, and 400 Agatston units, respectively. Compared with the group in the first quartile, the other three CVH groups had a lower odds ratio of CAC >0 after adjusting for age, sex, income level, education level, and alcohol use in the logistic regression analysis. The odds ratios in these groups were 0.86 [95% confidence interval (CI), 0.63-1.17; P<0.05], 0.75 (95% CI, 0.55-1.02; P<0.05), and 0.49 (95% CI, 0.35-0.69; P<0.05), respectively. These associations of CAC with the CVH metrics were consistent when different CAC cutoff scores were used (0, 10, 100, or 400).</p><p><b>CONCLUSION</b>The participants with more-ideal cardiovascular metrics had a lower prevalence of subclinical atherosclerosis determined according to CAC score. Maintaining an ideal cardiovascular health may be valuable in the prevention of atherosclerosis in the general population.</p>