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Cardiovascular health and atrial fibrillation
  1. Itamar S Santos1,2,
  2. Isabela M Bensenor1,2
  1. 1 Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
  2. 2 Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
  1. Correspondence to Dr Itamar S Santos, Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, SP 05508-000, Brazil; itamarss{at}

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The American Heart Association (AHA) has set decade-long impact goals since the 90s, aimed on reducing the cardiovascular disease (CVD) burden, with reflections on patient care and cardiovascular research around the globe. The last completed cycle ended in 2020. In that cycle, the objective was ‘by 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from CVDs and stroke by 20%’.1

The main strategy to achieve this goal was aligned with the foundations of primary prevention by Geoffrey Rose,2 and advocated that interventions should focus on increasing the proportion of individuals free of CVD with ideal (1) diet, (2) physical activity, (3) body mass index (BMI), (4) blood pressure, (5) fasting plasma glucose and (6) total cholesterol, as well as of (7) non-smokers (never smokers or, alternatively, past smokers with at least 1 year from quitting). This has also resulted in a 7-point ideal cardiovascular health (CVH) score, with specific metrics for each risk factor profile. Since then, several articles have used the CVH score, analysing the prevalence of ideal metrics in different populations, or measuring its association with CVD.3 4

In the present decade, the AHA has adopted even more ambitious aims. For 2030, the AHA aims an equitable increase in health-adjusted life expectancy (HALE) from 66 …

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  • Contributors IS and IB collaboratively wrote this editorial.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; externally peer reviewed.

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