Study finds few meet criteria for healthy cardiovascular lifestyle

When it comes to taking care of our hearts, there is a big divide between what we should do and what we actually do, a new multi-institution study reports.

“The fact that such a small number of people actually meet all of the healthy cardiovascular lifestyle criteria highlights that there is still a big gap with current lifestyle practices,” said Thomas Wang, M.D., director of the Division of Cardiovascular Medicine and Gottlieb C. Friesinger II Professor of Cardiovascular Medicine, who was one of the researchers on the study.

The research published recently in Circulation investigated the correlation between lifestyle factors associated with increased risk of cardiovascular disease (CVD) and CVD incidence.

Those risk factors have been boiled down to seven items that collectively are used to calculate a cardiovascular health (CVH) score.

They are: 1) non-smoking status, (2) body mass index, (3) physical activity, (4) diet, and a favorable profile of (5) serum cholesterol, (6) blood pressure and (7) blood glucose.

CVH score is inversely correlated with disease incidence; a higher score is indicative of a healthier heart.

The study reported that less than 1 percent of 2,680 healthy middle-age participants of the study met the ideal CVH score criteria, and more than 8 percent failed to meet the ideal CVH score for at least six of the seven lifestyle factors.

The epidemiological study followed the Framingham Heart Study Offspring cohort over a span of three years. After excluding patients with overt CVD (such as a history of heart attack or stroke), subjects were given CVH score based on the seven lifestyle factors. At the end of the study period, the participants underwent several tests to assess presence of sub-clinical disease, characterized by abnormalities in heart function, blood vessel function and blood vessel anatomy, among other markers. Circulating concentrations of 12 CVD-related biomarkers, indicative of subclinical CVD were also measured. The study went on to correlate these measurements to CVH score and CVD disease incidence.

Researchers found, as expected, that higher CVH score (more healthy lifestyle factors) correlated with lower prevalence of subclinical CVD and also with lower risk of overt CVD incidence.

This suggests that at least some of the reduction in heart attack or stroke as a result of high CVH score may be associated with a lower burden of subclinical disease at baseline and a more favorable biomarker profile.

While Wang said the results are intuitive, the research is valuable because it clearly demonstrates that lifestyle behaviors are correlated with disease risk.

“It basically reinforces the concept that healthy lifestyle factors are associated with lower burden of both subclinical and overt disease,” he said. “Demonstrating these associations helps highlight the importance of these healthy lifestyle factors.”

Wang says future studies might look at the mechanistic basis of how these healthy lifestyle factors affect cardiovascular health, and could help design clinical interventions in addition to healthy lifestyle recommendations.

He added that future studies may also help develop optimal screening that can find people at high cardiovascular risk and inform what sort of interventions can be done to promote better cardiovascular health.

In addition to Vanderbilt, the multi-institutional study was conducted by researchers at Boston University, Tufts University, Hannover Medical School in Germany, Massachusetts General Hospital, Harvard University, and Royal North Shore Hospital in Sydney, Australia.

The study was supported by AHA Clinical Research Program award 13CRP14090010 (VX), contract N01-HC-25915 (from the NHLBI), and by the DeSanctis Clinical Scholar Endowment.