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Journal Title:

Journal of the American Heart Association


Volume 3, Number 1


American Heart Association: JAHA | 2014-02-01, Pages e000282-e000282

Type of Work:

Article | Final Publisher PDF

Abstract: The American Heart Association AHA recently developed the Cardiovascular Health Index CVHI, a health metric consisting of 7 modifiable risk factors. The relationship of the CVHI with preclinical markers, such as carotid intima-media thickness CIMT has not been assessed. We examined 490 male monozygotic and dizygotic twins without overt cardiovascular disease. CIMT was measured using B-mode ultrasonography. Each of the 7 CVHI components blood pressure, fasting glucose, total cholesterol, body mass index, physical activity, healthy diet, and smoking was given a point score of 0, 1, or 2 to represent poor, intermediate, or ideal health, respectively. A CVHI summation score was computed range 0 to 14 and categorized as inadequate 0 to 4, average 5 to 9, or optimum 10 to 14 cardiovascular health. Mixed-model regression was used to examine the association of the CVHI with CIMT. The mean age of the twins was 55.4 years, and 61% were monozygotic. The mean CIMT was 0.75 ± 0.11 mm and the mean CVHI score was 7.7 ± 2.1. There was an inverse correlation between CVHI and CIMT Spearman r=-0.22, P<0.01. For every 5-unit increase in overall CVHI score indicating better cardiovascular health category, CIMT decreased by 0.045 mm P<0.001 after adjusting for demographic variables and other confounders. Within monozygotic twin pairs, a 5-unit increment in CVHI score was associated with a 0.05 mm lower CIMT P<0.001. The CVHI is independently associated with CIMT and the association is not confounded by shared genetic and other familial factors.

Subjects: Health Sciences, Epidemiology - Psychology, General - Research Funding: This study was supported by K24HL077506, R01 HL68630, and R01 AG026255 to Dr Vaccarino, and by K24 MH076955, R01 MH056120, and R01 HL088726 to Dr Bremner from the National Institutes of Health; by the Emory University General Clinical Research Center MO1‐RR00039 and by grant 0245115N from the American Heart Association.

The United States Department of Veterans Affairs has provided financial support for the development and maintenance of the Vietnam Era Twin VET Registry.

Numerous organizations have provided invaluable assistance, including: VA Cooperative Study Program; Department of Defense; National Personnel Records Center, National Archives and Records Administration; the Internal Revenue Service; National Opinion Research Center; National Research Council, National Academy of Sciences; and the Institute for Survey Research, Temple University.

Dr Eufinger is supported on F31 HL107080.

Keywords: Science and Technology - Life Sciences and Biomedicine - Cardiac and Cardiovascular Systems - Cardiovascular System and Cardiology - epidemiology - prevention - risk factors - AMERICAN-HEART-ASSOCIATION - MIDDLE-AGED MEN - RISK-FACTORS - ATHEROSCLEROSIS RISK - MYOCARDIAL-INFARCTION - DISEASE INCIDENCE - NORTHERN MANHATTAN - PHYSICAL-ACTIVITY - WALL THICKNESS - ARTERY INTIMA -

Autor: Ambar Kulshreshtha, Abhinav Goyal, Emir Veledar, William McClellan, Suzanne Judd, Silvia C. Eufinger, James Bremner, Jack Goldber



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