TY - JOUR
T1 - Less Than Ideal
T2 - Trends in Cardiovascular Health among US Stroke Survivors
AU - Lin, Amy M.
AU - Lin, Michelle P.
AU - Markovic, Daniela
AU - Ovbiagele, Bruce
AU - Sanossian, Nerses
AU - Towfighi, Amytis
N1 - Publisher Copyright:
© 2018 American Heart Association, Inc.
PY - 2019
Y1 - 2019
N2 - Background and Purpose - The American Heart Association's Life's Simple 7 (LS7) defines ideal cardiovascular health by 7 metrics: not smoking, regular physical activity, normal body mass index, blood pressure, plasma glucose, and total cholesterol levels, and a healthy diet. We assessed prevalence and predictors of ideal LS7 among US stroke survivors. Methods - Among 67 514 participants in the National Health and Nutrition Examination Surveys from 1988 to 1994 and 1999 to 2014, 1597 adults (≥18 years) had self-reported history of stroke. LS7 metrics were categorized as poor, intermediate, and ideal; ideal LS7 scores were calculated (1 point for each ideal metric met). Trends in poor, intermediate, and ideal cardiovascular health were assessed. Odds of low (0-1) versus high (≥4) ideal LS7 scores were assessed according to sex, race, poverty income ratio, and education level, before and after adjusting for covariates. Results - Only 1 participant met all ideal LS7 metrics. The proportion with low LS7 score increased from 17.9% in 1988 to 1994 to 35.4% in 2011 to 2014 (P<0.001). Over that time frame, prevalence of poor blood pressure (≥140/90 mm Hg) and poor cholesterol (≥240 mg/dL) decreased (45.2%-26.5% and 37.2%-10.3%), whereas prevalence of poor body mass index (≥30 kg/m2), poor diet (healthy eating index score <50), and poor physical activity (0 minutes moderate/vigorous activity per week) increased (26.9%-39.0%; 14.2%-50.6%; 44.6%-70.9%; all P<0.05). After adjustment, black race (odds ratio, 2.29; 95% CI, 1.17-4.48), poverty income ratio ≤200% (odds ratio, 2.20, 95% CI, 1.11-4.36), and ≤12th grade education (odds ratio, 4.50; 95% CI, 2.27-8.92) were associated with low ideal LS7 scores. Conclusions - Over the past 3 decades, blood pressure and cholesterol control among stroke survivors improved, but rates of obesity, poor diet, and physical inactivity increased. Stroke survivors who are black, poor, or less educated are less likely to have ideal cardiovascular health.
AB - Background and Purpose - The American Heart Association's Life's Simple 7 (LS7) defines ideal cardiovascular health by 7 metrics: not smoking, regular physical activity, normal body mass index, blood pressure, plasma glucose, and total cholesterol levels, and a healthy diet. We assessed prevalence and predictors of ideal LS7 among US stroke survivors. Methods - Among 67 514 participants in the National Health and Nutrition Examination Surveys from 1988 to 1994 and 1999 to 2014, 1597 adults (≥18 years) had self-reported history of stroke. LS7 metrics were categorized as poor, intermediate, and ideal; ideal LS7 scores were calculated (1 point for each ideal metric met). Trends in poor, intermediate, and ideal cardiovascular health were assessed. Odds of low (0-1) versus high (≥4) ideal LS7 scores were assessed according to sex, race, poverty income ratio, and education level, before and after adjusting for covariates. Results - Only 1 participant met all ideal LS7 metrics. The proportion with low LS7 score increased from 17.9% in 1988 to 1994 to 35.4% in 2011 to 2014 (P<0.001). Over that time frame, prevalence of poor blood pressure (≥140/90 mm Hg) and poor cholesterol (≥240 mg/dL) decreased (45.2%-26.5% and 37.2%-10.3%), whereas prevalence of poor body mass index (≥30 kg/m2), poor diet (healthy eating index score <50), and poor physical activity (0 minutes moderate/vigorous activity per week) increased (26.9%-39.0%; 14.2%-50.6%; 44.6%-70.9%; all P<0.05). After adjustment, black race (odds ratio, 2.29; 95% CI, 1.17-4.48), poverty income ratio ≤200% (odds ratio, 2.20, 95% CI, 1.11-4.36), and ≤12th grade education (odds ratio, 4.50; 95% CI, 2.27-8.92) were associated with low ideal LS7 scores. Conclusions - Over the past 3 decades, blood pressure and cholesterol control among stroke survivors improved, but rates of obesity, poor diet, and physical inactivity increased. Stroke survivors who are black, poor, or less educated are less likely to have ideal cardiovascular health.
KW - American Heart Association
KW - blood pressure
KW - lifestyle
KW - risk factors
KW - stroke
KW - trends
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UR - http://www.scopus.com/inward/citedby.url?scp=85075158632&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.118.022644
DO - 10.1161/STROKEAHA.118.022644
M3 - Article
C2 - 30580724
AN - SCOPUS:85075158632
SN - 0039-2499
VL - 50
SP - 5
EP - 12
JO - Stroke
JF - Stroke
IS - 1
ER -