American Heart Association’s Cardiovascular Health Metrics and Risk of Cardiovascular Disease Mortality Among a Middle-aged Male Scandinavian Population

Background: The burden of cardiovascular disease (CVD) prompted the American Heart Association to develop a cardiovascular health (CVH) metric as a measure to assess the cardiovascular status of the population. We aimed to assess the association between CVH scores and the risk of CVD mortality among a middle-aged Finnish population. Methods: We employed the prospective population-based Kuopio Ischemic Heart Disease cohort study comprising of middle-aged men (42 to 60 years). CVH scores were computed among 2,607 participants at baseline and categorized as optimum (0-4), average (5-9), or inadequate (10-14) CVH. Multivariate cox regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of CVH score for cardiovascular mortality. Results: During a median follow-up period of 25.8 years, 609 CVD mortality cases were recorded. The risk of CVD mortality increased gradually with increasing CVH score across the range 3-14 (p-value for non-linearity=0.77). Men with optimum CVH score had HR (95% CI) for CVD mortality of 0.30 (CI 0.21 – 0.42, p<0.0001) compared to those with inadequate CVH score after adjustment for conventional cardiovascular risk factors. Conclusions: CVH score was strongly and continuously associated with the risk of CVD mortality among middle-aged Finnish population and this was independent of other conventional risk factors.