Ideal Cardiovascular Health and Incident Cardiovascular Disease Among Adults: A Systematic Review and Meta-analysis Robinson Ramírez-Vélez, PhD, José M. Saavedra, PhD, Felipe Lobelo, PhD, Carlos A. Celis-Morales, PhD, Borja del Pozo-Cruz, PhD, Antonio García-Hermoso, PhD
Supplemental Material: Table S1. Search strategies. Table S2. Risk of bias within studies . Figure S1. Prevalence of ideal levels for each of the 7 metrics of cardiovascular health at baseline. Figure S2. Funnel plots for log hazard ratios of CVD events for ideal (A) and intermediate profile (B). Figure S3. Hazard Ratios (95% Confidence Interval) for cardiovascular events for ideal versus poor profile using only the studies with a scale of 0-7. Figure S4. Hazard Ratios (95% Confidence Interval) for cardiovascular events for intermediate versus poor profile using only the studies with a scale of 0-7.
Table S1. Search strategies. MEDLINE (2010- July 2017)
Key words
1 American heart association[MeSH Terms]
2 american heart association
3 #1 or #2
4 "cardiovascular health"
5 "ideal cardiovascular health"
6 "life's simple 7"
7 ideal health metrics
8 ideal cardiovascular health metrics
9 #4 or #5 or #6 or #7 or #8
10 #3 and #9
11 blood pressure[MeSH Terms]
12 Pressure, Blood
13 blood pressure
14 Systolic Pressure
15 Pressure, Systolic
16 Pressures, Systolic
17 Diastolic Pressure
18 Pressure, Diastolic
19 Pulse Pressure
20 Pressure, Pulse
21 #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20
22 Blood glucose[MeSH Terms]
23 Blood glucose
24 Blood Sugar
25 Sugar, Blood
26 Glucose, Blood
27 #22 or #23 or #24 or #25 or #26
28 Cholesterol[MeSH Terms]
29 Cholesterol
30 epicholesterol
31 #28 or #29 or #30
32 exercise[MeSH Terms]
33 exercise
34 physical fitness[MeSH Terms]
35 physical fitness
36 Exercise, Physical
37 Exercises, Physical
38 Physical Exercise
39 #32 or #33 or #34 or #35 or #36 or #37 or #38
40 diet[MeSH Terms]
41 diet
42 diets
43 #40 or #41 or #42
44 smoking[MeSH Terms]
45 smoking
46 Smokings, Tobacco
47 Tobacco Smokings
48 Smoking, Tobacco
49 #44 or #45 or #46 or #47 or #48
50 body mass index[MeSH Terms]
51 body mass index
52 Index, Body Mass
53 Quetelet Index
54 Index, Quetelet
55 Quetelet's Index
56 Quetelets Index
57 #50 or #51 or #52 or #53 or #54 or #55 or #56
58 #21 and #27 and #31 and #39 and #43 and #49 and #57
59 cardiovascular disease [MeSH Terms]
60 event
61 myocardial infarction [MeSH Terms]
62 infarction
63 myocardial
64 stroke [MeSH Terms]
65 heart failure [MeSH Terms]
66 heart
67 failure
68 venous thromboembolism [MeSH Terms]
69 venous
70 thromboembolism
71 coronary disease [MeSH Terms]
72 coronary
73 peripheral artery disease [MeSH Terms]
74 peripheral
75 #59 or #60 or #61 or #62 or #63 or #64 or #65 or #66 or #67 or #68 or #69 or #70 or #71 or #72 or #73 or #74
78 #75 Filters: Publication date from 2010/01/01
EMBASE (2010- July 2017)
Key words
1 'blood pressure'/exp
2 blood pressure'
3 cholesterol'/exp
4 cholesterol
5 epicholesterol
6 glucose blood level'/exp
7 'blood glucose'
8 'exercise'/exp
9 exercise
10 fitness
11 'diet'/exp
12 diet
13 diets
14 'body mass'/exp
15 'body mass index'
16 'quetelet index'
17 'somking'/exp
18 smoking
19 tobacco
20 'behavior, smoking'
21 'smoking behavior'
22 #1 or #2
23 #3 or #4 or #5
24 #6 or #7
25 #8 or #9 or #10
26 #11 or #12 or #13
27 #14 or #15 or #16
28 #17 or #18 or #19 or #20 or #21
29 #22 and #23 and #24 and #25 and #26 and #27 and #28
30 'American Heart association'
31 'Cardiovascular Health'
32 'Ideal Cardiovascular Health'
33 'Lifes simple 7'
34 'Life simple 7'
35 'Ideal Health Metrics'
36 'Ideal Cardiovascular Health Metrics'
37 #31 or #32 or #33 or #34 or #35 or #36
38 #30 and #37
39 'cardiovascular disease'
40 'myocardial infarction'
41 'stroke'
42 'heart failure'
43 'venous thromboembolism'
44 'coronary disease'
45 'peripheral artery disease'
46 #39 or #40 or #41 or #42 or #43 or #44 or #45
47 #29 or #38
48 #46 and #47
49 #46 and #57 and [2010-2017]/py
CINAHL (2010- July 2017)
Key words
1 MeSH descriptor: [American Heart Association] explode all trees
2 "American heart association"
3 #1 or #2
4 Cardiovascular Health
5 ideal cardiovascular health
6 Life’s simple 7
7 ideal health metrics
8 ideal cardiovascular health metrics
9 #4 or #5 or #6 or #7 or #8
10 #9 and #3
11 MeSH descriptor: [Blood Pressure] explode all trees
12 blood pressure
13 Pressure, Blood
14 Systolic Pressure
15 Pressure, Systolic
16 Pressures, Systolic
17 Diastolic Pressure
18 Pressure, Diastolic
19 Pulse Pressure
20 Pressure, Pulse
21 #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20
22 MeSH descriptor: [Blood Glucose] explode all trees
23 blood glucose
24 Blood Sugar
25 Sugar, Blood
26 Glucose, Blood
27 #22 or #23 or #24 or #25 or #26
28 MeSH descriptor: [Cholesterol] explode all trees
29 Cholesterol
30 Epicholesterol
31 #28 or #29 or #30
32 MeSH descriptor: [Exercise] explode all trees
33 exercise
34 MeSH descriptor: [Physical Fitness] explode all trees
35 physical fitness
36 Exercise, Physical
37 Exercises, Physical
38 Physical Exercise
39 #32 or #33 or #34 or #35 or #36 or #37 or #38
40 MeSH descriptor: [Diet] explode all trees
41 diet
42 diets
43 #40 or #41 or #42
44 MeSH descriptor: [Body Mass Index] explode all trees
45 body mass index
46 Index, Body Mass
47 Quetelet Index
48 Index, Quetelet
49 Quetelet's Index
50 Quetelets Index
51 #44 or #45 or #46 or #47 or #48 or #49
52 MeSH descriptor: [Smoking] explode all trees
53 smoking
54 Smokings, Tobacco
55 Tobacco Smokings
56 Smoking, Tobacco
57 #52 or #53 or #56
58 #21 and #27 and #31 and #39 and #43 and #51 and #57
59 #10 or #58
60 MeSH descriptor: [cardiovascular disease] explode all trees
61 'cardiovascular disease'
62 'myocardial infarction'
63 'stroke'
64 'heart failure'
65 'venous thromboembolism'
66 'coronary disease'
67 'peripheral artery disease'
75 #60 or #61 or #62 or #63 or #64 or #65 or #66 or #67
84 #59 and #75 Publication Year from 2010 to 2017
Figure S1. Prevalence of ideal levels for each of the 7 metrics of cardiovascular health at baseline. Favorable health behaviors: smoking abstention in the last year, ideal body mass index, physical activity and consumption of a diet that promotes cardiovascular health; and health factors: untreated total cholesterol< 200 mg/dl, untreated blood pressure <120/80 mm/Hg, and absence of diabetes mellitus. BMI, body mass index; BP, blood pressure; PA, physical activity; TC, total cholesterol.
Table S2. Risk of bias within studies .
Reference
Selection Comparability Outcome Score Representative of
cohort:
1. Representative 2. Not
representative 3. No description
Selection of non-exposed
cohort
1. Same community 2. Different community
3. No description
Ascertainment of CVD
1. Same for whole cohort 2. Different
among cohort 3. No
description
Outcome of interest was not present at baseline
1. Yes 2. No
3. Inapplicable
Controls for sex
1. Yes 2. No
Controls for age
and race-
ethnicity
1. Yes 2. No
Assessment of outcome
1. Objective 2. Structured
interview 3. Self-report
4. No description
Follow up for
outcome to occur
1. Long enough 2. Not long
enough
Lost-to-follow-up
1. Non 2. <
10%/year 3. >
10%/year 4. No
statement 5.
Inapplicable
Total
Dong et al. 2012
2 1 1 1 1 1 1 1 1 8/9
Folsom et al. 2011
1 1 1 1 1 1 1 1 2 8/9
Folsom et al. 2015
1 1 1 1 1 1 1 1 2 8/9
Folsom et al. 2015
1 1 1 1 1 1 1 1 2 8/9
Gaye et al. 2017
2 1 1 1 1 2 1 1 1 7/9
Kulshreshtha et al. 2013
1 1 1 1 1 1 1 2 1 8/9
Lachman et al. 2015
2 1 1 1 1 2 1 1 1 7/9
Miao et al. 2015
1 1 1 1 1 2 1 1 1 8/9
Nayor et al. 2016
2 1 1 1 1 2 1 1 1 7/9
Ogunmoroti et al. 2017
1 1 1 1 1 1 1 1 1 9/9
Olson et al. 2015
1 1 1 1 1 1 1 1 2 8/9
Ommerborn et al. 2016
1 1 1 1 1 2 1 1 2 7/9
Figure S2. Funnel plots for log hazard ratios of CVD events for ideal (A) and intermediate profile (B).
Figure S3. Hazard Ratios (95% Confidence Interval) for cardiovascular events for ideal versus poor profile using only the studies with a scale of 0-7.
Figure S4. Hazard Ratios (95% Confidence Interval) for cardiovascular events for intermediate versus poor profile using only the studies with a scale of 0-7.