Hyeok-Hee Lee, Jong Hyun Jhee, Eun-Jin Kim, Dasom Son, Hyeon Chang Kim, Donald M Lloyd-Jones, Hokyou Lee
{"title":"年轻人理想心血管健康评分与心血管肾脏预后的关系","authors":"Hyeok-Hee Lee, Jong Hyun Jhee, Eun-Jin Kim, Dasom Son, Hyeon Chang Kim, Donald M Lloyd-Jones, Hokyou Lee","doi":"10.1053/j.ajkd.2025.03.024","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale & objective: </strong>The linkage between cardiovascular disease (CVD) and kidney disease and the importance of promoting cardiovascular health (CVH) to prevent them are increasingly recognized. This study investigated the associations of ideal CVH and its longitudinal change with cardiovascular-kidney outcomes in young adults.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting & participants: </strong>From nationwide health screening data, we identified adults aged 20-39 without prior CVD or kidney disease who underwent baseline health examinations in 2009-2010 (N=3,836,626).</p><p><strong>Exposures: </strong>Using a modified American Heart Association's Life's Simple 7 construct excluding dietary data, participants were categorized according to the number of ideal CVH score components they met. Participants who underwent follow-up health examinations between 2011 and 2014 (N=2,728,675) were additionally categorized by the combination of baseline and follow-up CVH scores.</p><p><strong>Outcome: </strong>A composite of a cardiovascular or kidney event. Cardiovascular events included myocardial infarction, ischemic stroke, heart failure, and death from CVD. Kidney event included incident chronic kidney disease, kidney replacement therapy, and death from kidney disease.</p><p><strong>Analytical approach: </strong>Cause-specific proportional hazards model.</p><p><strong>Results: </strong>During a median follow-up of 12.1 years, 134,317 composite cardiovascular or kidney events occurred. Multivariable-adjusted risk of the event decreased stepwise with higher CVH scores (for a CVH score of 6 vs. 0: HR 0.32 [95% CI, 0.30-0.34]). An increase in CVH score from baseline (2009-2010) to follow-up (2011-2014) examination was associated with lower risk of an event (HR 0.86 [95% CI, 0.86-0.87] per +1 CVH score change). Moreover, the risk was lower in participants who maintained high CVH scores at both baseline and follow-up examinations than in those who newly achieved a high CVH score at follow-up examination (HR 0.87 [95% CI, 0.86-0.87] per +1 baseline CVH score).</p><p><strong>Limitations: </strong>Diet data were not included in CVH score.</p><p><strong>Conclusions: </strong>In young adults, achieving and maintaining high CVH were associated with reduced risk of cardiovascular-kidney outcomes.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of Ideal Cardiovascular Health Score and Cardiovascular-Kidney Outcomes in Young Adults.\",\"authors\":\"Hyeok-Hee Lee, Jong Hyun Jhee, Eun-Jin Kim, Dasom Son, Hyeon Chang Kim, Donald M Lloyd-Jones, Hokyou Lee\",\"doi\":\"10.1053/j.ajkd.2025.03.024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Rationale & objective: </strong>The linkage between cardiovascular disease (CVD) and kidney disease and the importance of promoting cardiovascular health (CVH) to prevent them are increasingly recognized. This study investigated the associations of ideal CVH and its longitudinal change with cardiovascular-kidney outcomes in young adults.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting & participants: </strong>From nationwide health screening data, we identified adults aged 20-39 without prior CVD or kidney disease who underwent baseline health examinations in 2009-2010 (N=3,836,626).</p><p><strong>Exposures: </strong>Using a modified American Heart Association's Life's Simple 7 construct excluding dietary data, participants were categorized according to the number of ideal CVH score components they met. Participants who underwent follow-up health examinations between 2011 and 2014 (N=2,728,675) were additionally categorized by the combination of baseline and follow-up CVH scores.</p><p><strong>Outcome: </strong>A composite of a cardiovascular or kidney event. Cardiovascular events included myocardial infarction, ischemic stroke, heart failure, and death from CVD. Kidney event included incident chronic kidney disease, kidney replacement therapy, and death from kidney disease.</p><p><strong>Analytical approach: </strong>Cause-specific proportional hazards model.</p><p><strong>Results: </strong>During a median follow-up of 12.1 years, 134,317 composite cardiovascular or kidney events occurred. Multivariable-adjusted risk of the event decreased stepwise with higher CVH scores (for a CVH score of 6 vs. 0: HR 0.32 [95% CI, 0.30-0.34]). An increase in CVH score from baseline (2009-2010) to follow-up (2011-2014) examination was associated with lower risk of an event (HR 0.86 [95% CI, 0.86-0.87] per +1 CVH score change). Moreover, the risk was lower in participants who maintained high CVH scores at both baseline and follow-up examinations than in those who newly achieved a high CVH score at follow-up examination (HR 0.87 [95% CI, 0.86-0.87] per +1 baseline CVH score).</p><p><strong>Limitations: </strong>Diet data were not included in CVH score.</p><p><strong>Conclusions: </strong>In young adults, achieving and maintaining high CVH were associated with reduced risk of cardiovascular-kidney outcomes.</p>\",\"PeriodicalId\":7419,\"journal\":{\"name\":\"American Journal of Kidney Diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":9.4000,\"publicationDate\":\"2025-06-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Kidney Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.ajkd.2025.03.024\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Kidney Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.ajkd.2025.03.024","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Association of Ideal Cardiovascular Health Score and Cardiovascular-Kidney Outcomes in Young Adults.
Rationale & objective: The linkage between cardiovascular disease (CVD) and kidney disease and the importance of promoting cardiovascular health (CVH) to prevent them are increasingly recognized. This study investigated the associations of ideal CVH and its longitudinal change with cardiovascular-kidney outcomes in young adults.
Study design: Retrospective cohort study.
Setting & participants: From nationwide health screening data, we identified adults aged 20-39 without prior CVD or kidney disease who underwent baseline health examinations in 2009-2010 (N=3,836,626).
Exposures: Using a modified American Heart Association's Life's Simple 7 construct excluding dietary data, participants were categorized according to the number of ideal CVH score components they met. Participants who underwent follow-up health examinations between 2011 and 2014 (N=2,728,675) were additionally categorized by the combination of baseline and follow-up CVH scores.
Outcome: A composite of a cardiovascular or kidney event. Cardiovascular events included myocardial infarction, ischemic stroke, heart failure, and death from CVD. Kidney event included incident chronic kidney disease, kidney replacement therapy, and death from kidney disease.
Results: During a median follow-up of 12.1 years, 134,317 composite cardiovascular or kidney events occurred. Multivariable-adjusted risk of the event decreased stepwise with higher CVH scores (for a CVH score of 6 vs. 0: HR 0.32 [95% CI, 0.30-0.34]). An increase in CVH score from baseline (2009-2010) to follow-up (2011-2014) examination was associated with lower risk of an event (HR 0.86 [95% CI, 0.86-0.87] per +1 CVH score change). Moreover, the risk was lower in participants who maintained high CVH scores at both baseline and follow-up examinations than in those who newly achieved a high CVH score at follow-up examination (HR 0.87 [95% CI, 0.86-0.87] per +1 baseline CVH score).
Limitations: Diet data were not included in CVH score.
Conclusions: In young adults, achieving and maintaining high CVH were associated with reduced risk of cardiovascular-kidney outcomes.
期刊介绍：
The American Journal of Kidney Diseases (AJKD), the National Kidney Foundation's official journal, is globally recognized for its leadership in clinical nephrology content. Monthly, AJKD publishes original investigations on kidney diseases, hypertension, dialysis therapies, and kidney transplantation. Rigorous peer-review, statistical scrutiny, and a structured format characterize the publication process. Each issue includes case reports unveiling new diseases and potential therapeutic strategies.
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