Ideal cardiovascular health during adult life and cardiovascular structure and function among the elderly

Amil M. Shah, Brian Claggett, Aaron R. Folsom, Pamela L. Lutsey, Christie M. Ballantyne, Gerardo Heiss, Scott D. Solomon

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Background - A higher American Heart Association cardiovascular health score (CVHS) predicts a lower incidence of cardiovascular disease (CVD). However, the relationship of CVHS attainment through midlife to late life with CVD prevalence and cardiovascular structure and function in late life is not well described. Methods and Results - The following 6 ideal cardiovascular health metrics were assessed in the Atherosclerosis Risk in Communities (ARIC) study participants at 5 examination visits between 1987 and 2013: nonsmoking, body mass index <25 kg/m 2, untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, fasting blood glucose <100 mg/dL, and ideal physical activity. Attainment over time was assessed as the percentage of maximum possible CVHS metrics achieved at visits 1 through 5, the slope of change in CVHS per decade of follow-up, and CVHS trajectory through follow-up. At visit 5, participant groups were characterized with respect to CVD prevalence (n=6520) and echocardiographic measures of cardiac structure and function (n=5903 free of CVD). CVHS was low at baseline and declined with age. Both greater CVHS attainment and improvement in CVHS during follow-up were associated with a lower prevalence of CVD and better left ventricular structure and systolic and diastolic function at visit 5. Conclusions - Greater attainment of, and improvements in, ideal cardiovascular health through midlife to late life are associated with lower CVD prevalence and better cardiovascular structure and function when elderly. These findings highlight the importance of consistent primordial and primary prevention efforts throughout midlife to late life as a potential intervention to decrease the burden of CVD among the elderly.

Original languageEnglish (US)
Pages (from-to)1979-1989
Number of pages11
Issue number21
StatePublished - Nov 24 2015

Bibliographical note

Publisher Copyright:
© 2015 American Heart Association, Inc.


  • aging
  • cardiovascular diseases
  • echocardiography
  • epidemiology
  • risk factors


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