A better way to assess cardiovascular health
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Lower body mass index (BMI), blood pressure and cholesterol were not always the most important factors when considering a person’s overall risk of dying, University of Queensland research has concluded.
Key points
- The accuracy of a cardiovascular assessment tool could more accurately predict the risk of dying by rescoring key metrics.
- The study challenges the belief that lower weight, blood pressure and cholesterol is better for everyone.
- The findings support ongoing efforts to improve cardiovascular health assessment tools and guide targeted prevention strategies.
Dr Yang Peng, from UQ’s Northside Clinical Unit at Prince Charles Hospital, used the data of 32,076 adults to analyse the American Heart Association’s cardiovascular health assessment tool, Life's Essential 8 (LE8), as a predictor of mortality risk.
“The LE8 score is composed of 8 factors – diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure,” Dr Peng said.
“My findings suggest that the current scoring of some metrics may not accurately reflect health risks.
“For example, individuals with a BMI between 25 and 29.9 had the lowest risk of mortality from all-causes and cardiovascular disease, suggesting they should receive the highest score for the BMI metric.
“However, the current LE8 scoring system assigned the highest score to those with a BMI less than 25.
According to the World Health Organization, a healthy BMI range for adults is between 18.5 and 24.9.
“These findings challenge the belief that lower is always better, particularly when it comes to weight, blood pressure and cholesterol,” Dr Peng said.
“Weight loss in mid‐to-late life is a warning sign for adverse outcomes and setting aggressive blood pressure targets in older adults can reduce blood flow to important organs.
“That’s why it’s important to establish personalised goals tailored to each individual’s unique circumstances.”
Using the original LE8 model, the study found people with good cardiovascular health had a 58 per cent lower risk of death overall and a 64 per cent lower risk of dying from heart disease when compared with those with poorer cardiovascular health,” Dr Peng said.
“But when I applied the new modelling, those risk reductions increased by up to 75 per cent and 87 per cent respectively.
“These findings support ongoing efforts to improve cardiovascular health assessment tools and guide targeted prevention strategies.”
The study used data from American adults in the National Health and Nutrition Examination Survey 2005 - 2018 and the National Death Index records.
The research was published in the International Journal of Cardiology: Cardiovascular Risk and Prevention.
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