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Original research
Ideal cardiovascular health duration and risk of chronic kidney disease and cardiovascular disease
  1. So Mi Jemma Cho1,2,
  2. Justin Y Jeon3,
  3. Tae-Hyun Yoo4,5,
  4. Hae-Young Lee6,7,
  5. Yong-ho Lee4,8,
  6. Hyeon Chang Kim4,9
  1. 1Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Eli and Edythe L. Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
  2. 2Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
  4. 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
  5. 5Institute of Kidney Research, Yonsei University College of Medicine, Seoul, Republic of Korea
  6. 6Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
  7. 7Division of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea
  8. 8Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
  9. 9Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Dr Hyeon Chang Kim, Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (the Republic of); hckim{at}yuhs.ac

Abstract

Objective Increasing number of clinical guidelines are adopting comprehensive cardiovascular risk assessment tools for treatment decision and disease management. Yet, little is known regarding cardiovascular risks associated with the length of favourable cardiometabolic profile. In this context, we examined whether the duration of strictly ideal cardiovascular health (CVH), based on body mass index, blood pressure, fasting glucose, total cholesterol, cigarette smoking, alcohol drinking and physical activity, in middle age is associated with risk of developing chronic kidney disease (CKD) and cardiovascular disease (CVD) in mid-to-late life.

Methods From the Korean Genome and Epidemiology Study Ansung-Ansan cohort, we included 8020 participants (median age 50.0 years, 47.9% male), of whom, 7854 without CKD and 7796 without CVD at baseline. Cox proportional hazards models were employed to assess CKD and CVD risks, adjusting for age, sex, education level, examination sites and renal markers.

Results Over a median follow-up of 15.0 years, 1401 cases of CKD and 493 cases of CVD were newly developed. Compared with participants with <5 years of ideal CVH duration, HR (95% CI) of those who maintained for 5–<10 years or ≥10 years had negatively graded risks for CKD (5–<10 years, 0.63 (0.39 to 0.93); ≥10 years, 0.33 (0.15 to 0.74)) and CVD (5–<10 years, 0.83 (0.54 to 1.27); ≥10 years, 0.22 (0.08 to 0.60)). In parallel, participants with delayed decline to suboptimal level had lower disease risks compared with counterparts with consistently suboptimal CVH.

Conclusion Our findings confer that maintaining favourable health behaviours and clinical risk factor levels in midlife will improve later-life cardiovascular outcomes.

  • risk factors
  • epidemiology

Data availability statement

Data are available upon reasonable request. The KoGES Ansung-Ansan data are available on reasonable request from the Korea Center for Disease Control and Prevention website.

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Data availability statement

Data are available upon reasonable request. The KoGES Ansung-Ansan data are available on reasonable request from the Korea Center for Disease Control and Prevention website.

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Footnotes

  • Contributors SMJC and HCK conceived and designed the study. SMJC performed statistical analyses. SMJC, JYJ, T-HY, H-YL, Y-HL and HCK interpreted the findings. SMJC drafted the manuscript. SMJC, JYJ, T-HY, H-YL, Y-HL and HCK made critical revision of the manuscript for key intellectual content. HCK takes full responsibility for the content of the manuscript, including data and analysis. All authors approved the final manuscript. HCK is the guarantor.

  • Funding This work was supported under the framework of international cooperation program managed by the National Research Foundation of Korea (NRF-2020K2A9A2A08000190).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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