Epidemiology and Prevention Ideal Cardiovascular Health and Mortality From All Causes and Diseases of the Circulatory System Among Adults in the United States

Background—Recently, the American Heart Association developed a set of 7 ideal health metrics that will be used to measure progress toward their 2020 goals for cardiovascular health. The objective of the present study was to examine how well these metrics predicted mortality from all causes and diseases of the circulatory system in a national sample of adults in the United States. Methods and Results—We used data from 7622 adults 20 years of age who participated in the National Health and Nutrition Examination Survey from 1999 to 2002 and whose mortality through 2006 was determined via linkage to the National Death Index. For the dietary and glycemic metrics, we used alternative measures. During a median follow-up of 5.8 years, 532 deaths (186 deaths resulting from diseases of the circulatory system) occurred. About 1.5% of participants met none of the 7 ideal cardiovascular health metrics, and 1.1% of participants met all 7 metrics. The number of ideal metrics was significantly and inversely related to mortality from all causes and diseases of the circulatory system. Compared with participants who met none of the ideal metrics, those meeting 5 metrics had a reduction of 78% (adjusted hazard ratio, 0.22; 95% confidence interval, 0.10–0.50) in the risk for all-cause mortality and 88% (adjusted hazard ratio, 0.12; 95% confidence interval, 0.03–0.57) in the risk for mortality from diseases of the circulatory system. Conclusion—The number of ideal cardiovascular health metrics is a strong predictor of mortality from all causes and diseases of the circulatory system. (Circulation. 2012;125:987-995.)