The Association between Ideal Cardiovascular Health and Risk of Sudden Cardiac Death and All-cause Mortality Among Finnish Middle-aged Men

Nzechukwu M Isiozor*, Setor K Kunutsor, Ari Voutilainen, Sudhir Kurl, Jussi Kauhanen, Jari A Laukkanen

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Background: Strong associations between American Heart Association’s cardiovascular health (CVH) metrics and various cardiovascular outcomes have been demonstrated, but the association with sudden cardiac death (SCD) is uncertain. We sought to examine the associations between the CVH metrics and the risks of SCD and all-cause mortality among men. 
Methods and results: We utilized the prospective population-based Kuopio Ischaemic Heart Disease cohort study comprising of men between 42 to 60 years at baseline. CVH metrics were computed for 2577 men at baseline with CVH scores ranging from 0 to 7, categorized into: ‘0 – 2’ (Poor), ‘3 – 4’ (Intermediate) and ‘5 -7’ (Ideal) CVH scores. Multivariate Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ideal CVH metrics for SCD and all-cause mortality. During a median follow-up period of 25.8 years, 280 SCDs and 1289 all-cause mortality events were recorded. The risks of SCD and all-cause mortality decreased continuously with increasing number of CVH metrics across the range 2-7 (p-value for nonlinearity for all<0.05). In multivariable analyses, men with ideal CVH score had 85% reduced risk of SCD when compared with those with poor CVH score (HR: 0.15; 95% CI: 0.05 – 0.48, p =0.001). For all-cause mortality, there was a 67% lower risk among men with ideal CVH score compared with those with poor CVH score (HR: 0.33; 95% CI: 0.23 – 0.49, p <0.001).
Conclusions: Ideal CVH metrics was strongly and linearly associated with the decreased risks of SCD and all-cause mortality among middle-aged men.
Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
Early online date31 Mar 2020
DOIs
Publication statusE-pub ahead of print - 31 Mar 2020

Keywords

  • cardiovascular health metrics
  • sudden cardiac death
  • all-cause mortality
  • risk factors
  • men

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