Ideal Cardiovascular Health, Cardiovascular Remodeling, and Heart Failure in Blacks

Blacks have a disproportionately higher risk and earlier onset of heart failure (HF) and cardiovascular mortality, relative to the overall American population. A prime contributor to this racial disparity is a higher prevalence and earlier onset of cardiometabolic disease, including obesity, hypertension, diabetes mellitus, and physical inactivity. Professional guidelines reinforcing ideal cardiovascular health target improvements in cardiometabolic health to prevent disease (“Life’s Simple 7”). However, recent data in over 5000 blacks from the JHS (Jackson Heart Study) indicate a low prevalence of ideal cardiovascular health characteristics (specifically diet, body mass index [BMI], and physical activity) with only modest improvements over time. In largely non-black populations, achievement of fewer Life’s Simple 7 components is associated with more adverse left ventricular (LV) remodeling and greater cardiovascular disease (CVD) and non-CVD mortality. Nevertheless, most prior work examining Simple 7 metrics has not focused on blacks to define axes of cardiometabolic health that most impact cardiovascular disease progression in this population. Original Article