Ideal Cardiovascular Health Score And Fuster-BEWAT Score As Predictors Of Left Ventricular Hypertrophy Classification

Background:The ideal cardiovascular health score?ICHS?is inversely associated with cardiovascular disease?CVD?incidence and is recommended for use in primary prevention.The Fuster-BEWAT score?FBS?,a health metric consisting of 5 modifiable risk factors?blood pressure,exercise,weight,alimentation,tobacco?,for promoting optimal cardiovascular health,exhibited comparable predictive values with ICHS in detecting the presence and extent of subclinical atherosclerosis.The aim of this study was to compare the effectiveness of ICHS and FBS in predicting the new 4-tiered classification system for left ventricular hypertrophy?LVH?.Methods:The cross-sectional study consisted of 11,261 general Chinese population?mean age 54 years;54%women?from Northeast China Rural Cardiovascular Health Study?NCRCHS?who were recruited from July 2012 to August 2013.The novel four geometric patterns of LVH were defined:neither increased concentricity⁰.67.67 nor increased LVEDV/BSA?“indeterminate hypertrophy”,n=1536?;increased LVEDV/BSA without increased concentricity^0.67?“dilated hypertrophy”,n=1240?;increased concentricity^0.67without increased LVEDV/BSA?“thick hypertrophy”,n=232?,and increased concentricity^0.67and LVEDV/BSA?“both thick and dilated hypertrophy”,n=185?.Results:With poor ICHS and FBS as references,individuals with ideal ICHS and FBS showed lower adjusted odds of having indeterminate hypertrophy?ICHS odds ratio[OR]:0.26;95%confidence interval[CI]:0.20 to 0.34 vs.FBS OR:0.28;95%CI:0.20 to 0.38?,dilated hypertrophy?OR:0.73;95%CI:0.57 to 0.94 vs.OR:0.57;95%CI:0.43 to 0.76?,thick hypertrophy?OR:0.12;95%CI:0.04 to 0.38 vs.OR:0.19;95%CI:0.07 to 0.52?,and both thick and dilated hypertrophy?OR:0.12;95%CI:0.03 to 0.37 vs.OR:0.26;95%CI:0.10 to 0.72?.Similar levels of significantly discriminating accuracy were found for ICHS and FBS with respect to the indeterminate hypertrophy?C-statistic:0.737;95%CI:0.725 to 0.750 vs.0.731;95%CI:0.718 to 0.744,respectively?,dilated hypertrophy?C-statistic:0.684;95%CI:0.670 to 0.699 vs.0.686;95%CI:0.671 to 0.701,respectively?,thick hypertrophy?C-statistic:0.658;95%CI:0.624 to 0.692 vs.0.650;95%CI:0.615 to 0.684,respectively?,and both thick and dilated hypertrophy?C-statistic:0.711;95%CI:0.678 to 0.744 vs.0.698;95%CI:0.663 to 0.733,respectively?.Conclusions:Our findings demonstrate that the FBS appears capable of performing just as well as does the ICHS in predicting the novel 4-group classification of LV geometric abnormalities,and is a simpler and more feasible option with which to offer fresh insight into alleviating LVH burden as part of primordial prevention of CVD.Improving the cardiovascular health?with the FBS as a metric?of the public with an advocacy for optimizing health behaviors and factors in settings where access to laboratory analysis is limited and health care resources are constrained may translate into a lower incidence of heart failure and CVD in the long term,perhaps in part by favorable influences on LV geometry.