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Ideal cardiovascular health and risk of acute myocardial infarction among Finnish men

  • Nzechukwu M. Isiozor
    Correspondence
    Corresponding author. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
    Affiliations
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • Setor K. Kunutsor
    Affiliations
    National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom

    Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Bristol, United Kingdom
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  • Ari Voutilainen
    Affiliations
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • Sudhir Kurl
    Affiliations
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • Jussi Kauhanen
    Affiliations
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • Jari A. Laukkanen
    Affiliations
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

    Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland

    Central Finland Health Care District, Department of Internal Medicine, Jyvaskyla, Finland
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      Highlights

      • Fewer participants achieved the ideal cardiovascular health.
      • The more cardiovascular health metrics, lower the risk of acute myocardial infarction.
      • ≥6 cardiovascular health metrics had 87% reduced risk of acute myocardial infarction.
      • Findings are consistent on further adjustments with covariates.

      Abstract

      Background and aims

      Acute myocardial infarction (AMI) is associated with high mortality globally and remains a public health burden. We sought to investigate the relation between the American Heart Association's cardiovascular health metrics (CVH) and the risk of AMI among middle-aged Finnish men.

      Methods

      We used the ongoing population-based Kuopio Ischaemic Heart Disease cohort study comprising men aged 40–62 years at baseline. The CVH metrics was computed among 2584 participants at baseline with health scores ranging from 0 to 7. This was categorized into three groups of CVH metrics as poor (0–2), intermediate (3–4) and ideal (≥5). Multivariate Cox regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of CVH metrics for AMI.

      Results

      During a median follow-up period of 25.2 years, 513 cases of AMI were recorded. Only one participant was able to achieve all the seven ideal health metrics. The risk of AMI decreased continuously with the increasing number of CVH metrics across the range 2–7 (for non-linearity, p = 0.07). Men with ideal CVH metrics had a HR (95% CI) for AMI of 0.28 (CI 0.15–0.55, p < 0.001) compared to those with poor CVH metrics after adjustment for age, alcohol intake and socioeconomic status. The associations remained consistent following further adjustment for history of coronary heart disease and history of type 2 diabetes.

      Conclusions

      Ideal CVH metrics was strongly and linearly associated with reduced risk of AMI among middle-aged Finnish men.

      Graphical abstract

      Keywords

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