Prevalence and Metrics Distribution of Ideal Cardiovascular Health: A Population-based, Cross-sectional Study in Rural China

Background The American Heart Association (AHA) introduced definitions of "ideal,'' "intermediate,'' and "poor'' cardiovascular health (CVH) based on seven cardiovascular health metrics (smoking, body mass index, physical activity, diet score, total cholesterol, blood pressure, and fasting glucose). This study used this construct to assess the prevalence and metric distribution of CVH in a rural population with traditional lifestyles and investigate the relationship of CVH with socio-demographic characteristics of participants. Methods From January 2012 to August 2013, a representative sample of 11,113 adults (mean age 53.8 +/- 10.6 years; 53.8% women) was enrolled from a rural population in Northeast China using a multi-stage, stratified random cluster-sampling scheme. Results According to the adjusted AHA criteria for CVH health metrics, there was 0.1% prevalence of ideal CVH (all seven health metrics at ideal levels), 11.7% of intermediate CVH (at least one health metric at intermediate level, but no poor health metrics), and 88.2% of poor CVH (at least one of seven health metrics at poor level). Women and young/middle-aged adults were more likely to have all of the ideal CVH metrics, behaviours, factors and CVH status. Conclusions Our study showed extremely low (0.1%) prevalence of ideal CVH in the rural population of northeast China. The poor CVH status, particularly among men and older individuals, underscores the need for urgent action on modifiable risk factors, especially blood pressure and smoking.