Effects Of Ideal Cardiovascular Behavior Factors On Cardiovascular And Cerebrovascular Events,all-cause Mortality

ObjectivesTo investigate the effects between Cardiovascular Health Scores(CHS)and the cardiocerebrovascular events and All-cause mortality.MethodsThe Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 97 years recruited in 2006–2007 and who were subsequently followed up at 2-(Exam 2),4-(Exam 3),and 6(Exam 4),and 8(Exam 5)-year intervals after baseline.The main analysis is restricted to those individuals with complete follow-up at all 3 examinations and who had no history of myocardial Infarction,stroke until Exam 3.Baseline study population were divided into four groups,to investigate the effects between Baseline Cardiovascular Health Scores(CHS)and the Risk of Myocardial Infarction,Stroke,All-cause mortality.Using the SAS Proc Traj software create the group-based Cardiovascular Health Score(CHS)trajectories.Cox hazards regression models were used to assess the association between the CHS trajectories and risk of myocardial Infarction,stroke,and all-cause mortality.Results1.A total of 92136 individuals(mean age :51.04±12.35 years;73198 males(79.4%)were under analysis.According to the four percentile of CHS,the study population was divided into four groups:(CHS<7)、(7≤CHS<9)、(9≤CHS<11)、(CHS≥11)。Compared with first group,the second group,the third group,the fourth group,the risk of cardiovascular events decrease by 28%,52% and 69%,respectively,the corresponding HR value(95% CI)were 0.72(0.66~0.78),0.48(0.44~0.52)and 0.44(0.27~0.35);The risk of all-cause mortality decrease by 15%,27% and 35%,respectively,the corresponding value of HR(95% CI)were 0.85(0.79~0.92),0.73(0.68~0.79)and 0.68(0.58~0.74).2.A total of 45143 individuals(mean age: 51.85±11.73 years;34698males,445females)were under analysis.During a mean follow-up of 4.96±0.54years(cardiovascular events)and 4.95±0.56 years(all-cause mortality),1004 cases of cardiovascular events,250 cases of myocardial Infarction,761 cases of stroke,1004 cases of all-cause mortality were identified.We identified 4 CHS trajectories: lowstable(n=2233,6.3%),the moderate-stable(n=13024,29.2%),moderate-elevated-stable(n=21427,43.5%),elevated-stable group(n=8459,21.0%).3.With the increase of CHS trajectories,the risk of cardiovascular events,myocardial Infarction,stroke,and all-cause mortality increased.In fully adjusted Cox models,compared with the low-stable group,individuals in the moderate-stable,moderate-elevated-stable,elevated-stable group had 0.71(0.57~0.90),0.52(0.40~0.67),0.31(0.21~0.45)lower risk for cardiovascular events.0.72(0.55~0.95,0.53(0.39~0.71,0.30(0.19~0.47)lower risk for stroke.Moderate-elevated-stable,elevated-stable group had 0.47(0.28~0.78),0.28(0.13~0.60)lower risk for myocardial Infarction.0.67(0.50~0.91),0.51(0.35~0.74)for all-cause mortality.The association remained similar in male,individuals age≥60 and age<60 years old,whereas attenuated in female.4.The results of sensitivity analyses were similar to the non-sensitivity analyses.The likelihood ratio test indicated that CHS trajectories fit the model better than the single baseline CHS.Conclusions1.There is a strong inverse relationship between the baseline CHS and the incidence of cardiocerebrovascular events and all-cause mortality.2.CHS trajectories is associated with a reduced incidence of cardiovascular events,myocardial Infarction,stroke,and all-cause mortality.3.CHS trajectories may have a better predict value than single CHS to the outcome events.