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Estimates of Mortality Benefit From Ideal Cardiovascular Health Metrics: A Dose Response Meta‐Analysis
Department of Biostatistics Faculty Publications
  • Ehimen C. Aneni, Mount Sinai Medical Center; Baptist Health South Florida
  • Alessio Crippa, Karolinska Institutet
  • Chukwuemeka U. Osondu, Baptist Health South Florida
  • Javier Valero‐Elizondo, Baptist Health South Florida; Cátedra de Cardiología y Medicina Vascular, Tecnológico de Monterrey (ITESM)
  • Adnan Younus, Baptist Health South Florida
  • Khurram Nasir, Department of Epidemiology and the Herbert Wertheim College of Medicine, Florida International University; Baptist Health Medical Group; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease
  • Emir Veledar, Department of Biostatistics, Florida International University; Baptist Health South Florida
Date of this Version
12-21-2017
Document Type
Article
Abstract

Background Several studies have shown an inverse relationship between ideal cardiovascular health (CVH) and mortality. However, there are no studies that pool these data to show the shape of the relationship and quantify the mortality benefit from ideal CVH.

Methods and Results We conducted a systematic internet literature search of multiple databases including MEDLINE, Web of Science, Embase, CINAHL, and Scopus for longitudinal studies assessing the relationship between ideal CVH and mortality in adults, published between January 1, 2010, and May 31, 2017. We included studies that assessed the relationship between ideal CVH and mortality in populations that were initially free of cardiovascular disease. We conducted a dose‐response meta‐analysis generating both study‐specific and pooled trends from the correlated log hazard ratio estimates of mortality across categories of ideal CVH metrics. A total of 6 studies were included in the meta‐analysis. All of the studies indicated a linear decrease in (cardiovascular disease and all‐cause) mortality with increasing ideal CVH metrics. Overall, each unit increase in CVH metrics was associated with a pooled hazard ratio for cardiovascular disease mortality of 0.81 (95% confidence interval, 0.75–0.87), while each unit increase in ideal CVH metrics was associated with a pooled hazard ratio of 0.89 (95% confidence interval, 0.86–0.93) for all‐cause mortality.

Conclusions Our meta‐analysis showed a strong inverse linear dose‐response relationship between ideal CVH metrics and both all‐cause and cardiovascular disease–related mortality. This study suggests that even modest improvements in CVH is associated with substantial mortality benefit, thus providing a strong public health message advocating for even the smallest improvements in lifestyle.

Comments

Originally published in Journal of the American Heart Association.

Creative Commons License
Creative Commons Attribution-Noncommercial 4.0
Citation Information
Ehimen C. Aneni, Alessio Crippa, Chukwuemeka U. Osondu, Javier Valero‐Elizondo, et al.. "Estimates of Mortality Benefit From Ideal Cardiovascular Health Metrics: A Dose Response Meta‐Analysis" (2017)
Available at: http://works.bepress.com/emir-veledar/27/