A1 Journal article (refereed)
American Heart Association’s Cardiovascular Health Metrics and Risk of Cardiovascular Disease Mortality Among a Middle-aged Male Scandinavian Population (2019)

Isiozor, N. M., Kunutsor, S. K., Voutilainen, A., Kurl, S., Kauhanen, J., & Laukkanen, J. A. (2019). American Heart Association’s Cardiovascular Health Metrics and Risk of Cardiovascular Disease Mortality Among a Middle-aged Male Scandinavian Population. Annals of Medicine, 51(5-6), 306-313. https://doi.org/10.1080/07853890.2019.1639808

JYU authors or editors

Publication details

All authors or editors: Isiozor, Nzechukwu M.; Kunutsor, Setor K.; Voutilainen, Ari; Kurl, Sudhir; Kauhanen, Jussi; Laukkanen, Jari A.

Journal or series: Annals of Medicine

ISSN: 0785-3890

eISSN: 1365-2060

Publication year: 2019

Volume: 51

Issue number: 5-6

Pages range: 306-313

Publisher: Taylor & Francis

Publication country: United Kingdom

Publication language: English

DOI: https://doi.org/10.1080/07853890.2019.1639808

Publication open access: Not open

Publication channel open access:


Background: The burden of cardiovascular disease (CVD) prompted the American Heart Association to develop a cardiovascular health (CVH) metric as a measure to assess the cardiovascular status of the population. We aimed to assess the association between CVH scores and the risk of CVD mortality among a middle-aged Finnish population.

Methods: We employed the prospective population-based Kuopio Ischemic Heart Disease cohort study comprising of middle-aged men (42 to 60 years). CVH scores were computed among 2,607 participants at baseline and categorized as optimum (0-4), average (5-9), or inadequate (10-14) CVH. Multivariate cox regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of CVH score for cardiovascular mortality.

Results: During a median follow-up period of 25.8 years, 609 CVD mortality cases were recorded. The risk of CVD mortality increased gradually with increasing CVH score across the range 3-14 (p-value for non-linearity =0.77). Men with optimum CVH score had HR (95% CI) for CVD mortality of 0.30 (CI 0.21 – 0.42, p < 0.0001) compared to those with inadequate CVH score after adjustment for conventional cardiovascular risk factors.

Conclusions: CVH score was strongly and continuously associated with the risk of CVD mortality among middle-aged Finnish population and this was independent of other conventional risk factors.

Key messages

Achieving optimum cardiovascular health score reduces the risk of cardiovascular mortality.

Adopting the American Heart Association’s cardiovascular health metrics is a welcome approach for public health awareness and monitoring of cardiovascular health among Scandinavian population.

Keywords: cardiovascular diseases; risk factors; mortality; middle-aged persons; men; measuring instruments (indicators)

Free keywords: cardiovascular disease; health metrics; health score; risk factor; cardiovascular mortality

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2019

JUFO rating: 2

Last updated on 2021-08-06 at 14:59