Less than one out of every 100 stroke survivors met all of the American Heart Association’s criteria for ideal cardiovascular health, researchers found.
The percentage of patients who met none or only one of the seven goals used to define ideal cardiovascular health increased from 18% in 1988-1994 to 33% in 2005-2010, and less than 1% achieved all seven goals, according to Michelle Lin, MD of the University of Southern California in Los Angeles.
The participants improved in some metrics over time, but worsened or remained stable in most, Lin reported at the annual meeting here of the American Academy of Neurology.
The seven health metrics — dubbed Life’s Simple 7 — were developed in 2010 by the American Heart Association, Lin noted. They include:
- Having a total cholesterol of less than 200 milligrams per deciliter.
- Having blood pressure below 120/80.
- Having a fasting blood glucose below 100 milligrams per deciliter.
- Having either never smoked, or quit more than a year ago.
- Having a body mass index of less than 25.
- Exercising at a moderate level for at least 150 minutes, or at an intense level for 75 minutes per week.
- Meeting four to five of the key components of a healthy diet in line with current heart association guidelines.
To see how stroke survivors match up over time, Lin and colleagues turned to the National Health and Nutrition Examination Survey (NHANES) for 1988-1994, 1999-2004, and 2005-2010.
To be able to use NHANES data, she noted, they modified the Simple 7 criteria in some cases. For instance, because NHANES investigators did not collect data on when participants quit smoking, Lin and colleagues defined them as simply current, former, or never smokers.
Over the three periods, she reported, the researchers found 1,293 stroke survivors with data for all seven metrics.
But, she said, less than 1% achieved an ideal score on all seven metrics — only two participants, both in the 2005-2010 period.
The proportion with metric scores of four or higher was stable over time — about 17% or 18% in each period, Lin reported — while the proportion of people with scores of two or three improved significantly over time (at P=0.01).
But that was because the proportion of people with a metric score of zero or one climbed sharply — 18% in 1988-1994, 24% in 1999-2004, and 33% in 2005-2010. The trend was significant at P=0.0007.
On the positive side, a comparison of survivors in 1988-1994 and 2005-2010 showed significant improvements in all three medical metrics.
The proportion of people with the worst level of cholesterol, for instance, fell from 37% to 16%, Lin said.
But the lifestyle metrics were a different story. The proportion who were overweight and weren’t eating a healthy diet rose significantly (at P<0.001 and P=0.004, respectively) while the proportion of never smokers and those with good exercise habits stayed stable.
The study “gives us a baseline for how badly we do at primary prevention,” commented Cheryl Bushnell, MD, of Wake Forest Baptist Health in Winston-Salem, N.C., who was not part of the study but who moderated a session at which it was presented.
The seven health metrics are a recent development, she told MedPage Today, and it will be interesting to see how they influence stroke survivors in the future.
But for many of the people whose illness was recorded in the data, “a poor health score is why they had a stroke in the first place.”
It’s important to note that over time the three medical metrics actually improved, she added, but lifestyle markers either were stable or worsened — a reflection of an increasingly sedentary nation.
From the American Heart Association:
North American Correspondent for MedPage Today, is a three-time winner of the Science and Society Journalism Award of the Canadian Science Writers’ Association. After working for newspapers in several parts of Canada, he was the science writer for the Toronto Star before becoming a freelancer in 1994. His byline has appeared in New Scientist, Science, the Globe and Mail, United Press International, Toronto Life, Canadian Business, the Toronto Star, Marketing Computers, and many others. He is based in Toronto, and when not transforming dense science into compelling prose he can usually be found sailing.
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