Association between ideal cardiovascular health and carotid intima-media thickness: a twin study.

The american heart association (aha) recently developed the cardiovascular health index (cvhi),a health metric consisting of 7 modifiable risk factors. the relationship of the cvhi with preclinical markers,such as carotid intima-media thickness (cimt) has not been assessed. we examined 490 male monozygotic and dizygotic twins without overt cardiovascular disease. cimt was measured using b-mode ultrasonography. each of the 7 cvhi components (blood pressure,fasting glucose,total cholesterol,body mass index,physical activity,healthy diet,and smoking) was given a point score of 0,1,or 2 to represent poor,intermediate,or ideal health,respectively. a cvhi summation score was computed (range 0 to 14) and categorized as inadequate (0 to 4),average (5 to 9),or optimum (10 to 14) cardiovascular health. mixed-model regression was used to examine the association of the cvhi with cimt. the mean age of the twins was 55.4 years,and 61% were monozygotic. the mean cimt was 0.75 (± 0.11) mm and the mean cvhi score was 7.7 (± 2.1). there was an inverse correlation between cvhi and cimt (spearman r=-0.22,p<0.01). for every 5-unit increase in overall cvhi score (indicating better cardiovascular health category),cimt decreased by 0.045 mm (p<0.001) after adjusting for demographic variables and other confounders. within monozygotic twin pairs,a 5-unit increment in cvhi score was associated with a 0.05 mm lower cimt (p<0.001). the cvhi is independently associated with cimt and the association is not confounded by shared genetic and other familial factors.