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      Prevalence of ideal cardiovascular health in the Brazilian adult population - National Health Survey 2019 Translated title: Prevalencia de salud cardiovascular ideal en la población adulta brasileña - Encuesta Nacional de Salud 2019 Translated title: Prevalência de saúde cardiovascular ideal na população adulta brasileira - Pesquisa Nacional de Saúde 2019

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      1 , 2 , 1 , 1
      Epidemiologia e Serviços de Saúde : Revista do Sistema Unico de Saúde do Brasil
      Secretaria de Vigilância em Saúde - Ministério da Saúde do Brasil
      Population Based Studies in Public Health, National Health Survey, Risk Factors of Cardiovascular Disease, Health Inequality, Cross-sectional Studies, Estudios Poblacionales en Salud Pública, Encuesta de Salud, Factores de Riesgo de Enfermedad Cardiovascular, Desigualdad en Salud, Tasa de Prevalencia, Epidemiología Descriptiva, Estudios Transversales, Estudos Populacionais em Saúde Pública, Inquérito Nacional de Saúde, Fatores de Risco de Doenças Cardíacas, Desigualdade em Saúde, Estudos Transversais.

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          Abstract

          Objective:

          to analyze the prevalence of ideal cardiovascular health (CVH) in the Brazilian adult population based on the 2019 National Health Survey.

          Methods:

          this was a population-based cross-sectional study (n = 77,494); prevalence and respective 95% confidence intervals (95%CI) of ideal CVH (seven metrics achieved simultaneously) and by individual metrics (four behavioral and three biological metrics), as defined by the American Heart Association, were estimated.

          Results:

          only 0.5% (95%CI 0.4;0.6) of the study population presented ideal CVH, with higher prevalence among those with higher level of education (1.3%; 95%CI 0.9;1.6) and residents in urban areas (0.6%; 95%CI 0.5;0.7); the prevalence of behavioral and biological metrics was 0.7% (95%CI 0.6;0.8) and 63.3% (95%CI 62.7;63.9) respectively.

          Conclusion:

          the prevalence of ideal CVH was very low, highlighting the need for public policies aimed at promotion, surveillance and CVH care in the Brazilian adult population.

          Resumo

          Objetivo:

          analisar a prevalência de saúde cardiovascular (SCV) ideal na população adulta brasileira.

          Métodos:

          estudo transversal com base na Pesquisa Nacional de Saúde de 2019 (n = 77.494); foram estimadas as prevalências e respectivos intervalos de confiança de 95% (IC 95%) de SCV ideal (sete metas alcançadas simultaneamente) e por metas individuais (quatro metas comportamentais; três biológicas), conforme propõe a Associação Americana do Coração.

          Resultados:

          apenas 0,5% (IC 95% 0,4;0,6) da população estudada apresentou SCV ideal, observando-se maior prevalência entre aqueles com maior escolaridade (1,3%; IC 95% 0,9;1,6) e os residentes em áreas urbanas (0,6%; IC 95% 0,5;0,7); as prevalências das metas comportamentais e biológicas foram de 0,7% (IC 95% 0,6;0,8) e 63,3% (IC 95% 62,7;63,9) respectivamente.

          Conclusão:

          a prevalência de SCV ideal foi muito baixa, evidenciando a necessidade de políticas públicas para promoção, vigilância e atenção à SCV na população adulta brasileira.

          Resumen

          Objetivo:

          analizar la prevalencia de salud cardiovascular (SCV) ideal en la población adulta brasileña con base en la Encuesta Nacional de Salud de 2019.

          Métodos:

          estudio transversal de base poblacional (n = 77.495). Según lo propuesto por la Asociación Americana del Corazón, la prevalencia y los intervalos de confianza del 95% (IC 95%) del SCV ideal se estimaron globalmente (siete metas alcanzadas simultáneamente) y por metas individuales (cuatro metas de comportamiento y tres metas). Se calculó la prevalencia de las metas por variables sociodemográficas.

          Resultados:

          sólo el 0,5% (IC 95% 0,4;0,6) de la población presentó SCV ideal, siendo más frecuente en aquellos con educación superior (1,3%; IC 95% 0,9;1,6) y entre los residentes de áreas urbanas (0,6%; IC 95%0,5;0,7). La prevalencia de las metas de comportamiento y biológicas fue de 0,7% (IC 95% 0,6;0,8) y 63,3% (IC 95% 62,7;63,9), respectivamente.

          Conclusión:

          la prevalencia de SCV ideal en adultos brasileños es muy baja, destacando la necesidad de políticas públicas para la promoción, vigilancia y atención a la SCV en la población adulta brasileña.

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          Most cited references35

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          Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study.

          Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries. Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown. We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent. 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here. Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated. Smoking (odds ratio 2.87 for current vs never, PAR 35.7% for current and former vs never), raised ApoB/ApoA1 ratio (3.25 for top vs lowest quintile, PAR 49.2% for top four quintiles vs lowest quintile), history of hypertension (1.91, PAR 17.9%), diabetes (2.37, PAR 9.9%), abdominal obesity (1.12 for top vs lowest tertile and 1.62 for middle vs lowest tertile, PAR 20.1% for top two tertiles vs lowest tertile), psychosocial factors (2.67, PAR 32.5%), daily consumption of fruits and vegetables (0.70, PAR 13.7% for lack of daily consumption), regular alcohol consumption (0.91, PAR 6.7%), and regular physical activity (0.86, PAR 12.2%), were all significantly related to acute myocardial infarction (p<0.0001 for all risk factors and p=0.03 for alcohol). These associations were noted in men and women, old and young, and in all regions of the world. Collectively, these nine risk factors accounted for 90% of the PAR in men and 94% in women. Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.
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            Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond.

            This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals for the organization. The committee was charged with defining a new concept, cardiovascular health, and determining the metrics needed to monitor it over time. Ideal cardiovascular health, a concept well supported in the literature, is defined by the presence of both ideal health behaviors (nonsmoking, body mass index <25 kg/m(2), physical activity at goal levels, and pursuit of a diet consistent with current guideline recommendations) and ideal health factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, and fasting blood glucose <100 mg/dL). Appropriate levels for children are also provided. With the use of levels that span the entire range of the same metrics, cardiovascular health status for the whole population is defined as poor, intermediate, or ideal. These metrics will be monitored to determine the changing prevalence of cardiovascular health status and define achievement of the Impact Goal. In addition, the committee recommends goals for further reductions in cardiovascular disease and stroke mortality. Thus, the committee recommends the following Impact Goals: "By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." These goals will require new strategic directions for the American Heart Association in its research, clinical, public health, and advocacy programs for cardiovascular health promotion and disease prevention in the next decade and beyond.
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              • Record: found
              • Abstract: found
              • Article: not found

              Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study

              Global estimates of the effect of common modifiable risk factors on cardiovascular disease and mortality are largely based on data from separate studies, using different methodologies. The Prospective Urban Rural Epidemiology (PURE) study overcomes these limitations by using similar methods to prospectively measure the effect of modifiable risk factors on cardiovascular disease and mortality across 21 countries (spanning five continents) grouped by different economic levels.
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                Author and article information

                Contributors
                Role: All authors contributed significantly to the study design, data analysis and interpretation and drafting of the manuscript. Collaborated with data analysis and interpretation, drafting and critical reviewing of the manuscript content. All authors have approved the final version of the manuscript and declared themselves to be responsible for all aspects of the work, including ensuring its accuracy and integrity.
                Role: All authors contributed significantly to the study design, data analysis and interpretation and drafting of the manuscript. Collaborated with the study conception and design, analysis and interpretation of the results, drafting and critical reviewing of the manuscript content. All authors have approved the final version of the manuscript and declared themselves to be responsible for all aspects of the work, including ensuring its accuracy and integrity.
                Role: All authors contributed significantly to the study design, data analysis and interpretation and drafting of the manuscript. Collaborated with data analysis and interpretation, drafting and critical reviewing of the manuscript content. All authors have approved the final version of the manuscript and declared themselves to be responsible for all aspects of the work, including ensuring its accuracy and integrity.
                Role: All authors contributed significantly to the study design, data analysis and interpretation and drafting of the manuscript. Collaborated with the study conception and design, analysis and interpretation of the results, drafting and critical reviewing of the manuscript content. All authors have approved the final version of the manuscript and declared themselves to be responsible for all aspects of the work, including ensuring its accuracy and integrity.
                Journal
                Epidemiol Serv Saude
                Epidemiol Serv Saude
                ress
                Epidemiologia e Serviços de Saúde : Revista do Sistema Unico de Saúde do Brasil
                Secretaria de Vigilância em Saúde - Ministério da Saúde do Brasil
                1679-4974
                2237-9622
                03 April 2023
                2023
                : 32
                : 1
                : e2022669
                Affiliations
                [1 ]Universidade de Brasília, Departamento de Estatística, Brasília, DF, Brazil
                [2 ]Universidade de Brasília, Colegiado de Bases Biológicas e da Saúde, Brasília, DF, Brazil
                Author notes
                [Correspondence: ] Ana Carolina Souto Valente Motta. [E-mail: ] anacarolina_souto@ 123456hotmail.com

                AUTHOR CONTRIBUTIONS: All authors contributed significantly to the study design, data analysis and interpretation and drafting of the manuscript. Motta ACSV and Motoki IHL collaborated with data analysis and interpretation, drafting and critical reviewing of the manuscript content. Bousquet-Santos KB and Andrade JML collaborated with the study conception and design, analysis and interpretation of the results, drafting and critical reviewing of the manuscript content. All authors have approved the final version of the manuscript and declared themselves to be responsible for all aspects of the work, including ensuring its accuracy and integrity.

                CONFLICTS OF INTEREST: The authors declare they have no conflicts of interest.

                Associate editor: Doroteia Aparecida Höfelmann - https://orcid.org/0000-0003-1046-3319

                Author information
                http://orcid.org/0000-0001-9016-4794
                http://orcid.org/0000-0002-4687-4681
                http://orcid.org/0000-0002-8316-921X
                http://orcid.org/0000-0002-3984-3799
                Article
                00309
                10.1590/S2237-96222023000300006
                10069666
                37018816
                c35f7ae7-156e-4df6-830a-84fba81493df

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 17 August 2022
                : 21 December 2022
                Page count
                Figures: 2, Tables: 10, Equations: 0, References: 30
                Categories
                Original Article

                population based studies in public health,national health survey,risk factors of cardiovascular disease,health inequality,cross-sectional studies,estudios poblacionales en salud pública,encuesta de salud,factores de riesgo de enfermedad cardiovascular,desigualdad en salud,tasa de prevalencia,epidemiología descriptiva,estudios transversales,estudos populacionais em saúde pública,inquérito nacional de saúde,fatores de risco de doenças cardíacas,desigualdade em saúde,estudos transversais.

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