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Couples Often Have Similar CV Risk Factors

Discussion in 'Cardiology' started by Dr.Scorpiowoman, Oct 30, 2020.

  1. Dr.Scorpiowoman

    Dr.Scorpiowoman Golden Member

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    Within couples, there was often similar adherence or nonadherence to ideal CV health behaviors, which may represent an opportunity for targeted risk factor modification, researchers reported.

    “This study suggests the abundance of couples who are both in a nonideal category of CV risk factors and behaviors that are amenable to lifestyle interventions,” Dov Shiffman, PhD, scientific fellow at Quest Diagnostics in Palo Alto, California, and colleagues wrote. “Overall, these observations may help inform public health initiatives that focus on couples-targeted lifestyle modification and may help improve the probability of successful implementation of programs that would benefit both members of a couple.”

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    For this analysis, 5,364 U.S. couples (54% white; median age, 50 years for men and 47 years for women) participated in an employer-sponsored health assessment program administered by Quest Diagnostics. Investigators assessed the rate of within-couple concordance of the American Heart Association’s Life’s Simple 7 (smoking status, BMI, exercise, diet, total cholesterol, BP and fasting glucose). For each category, participants received a CV health score of ideal, intermediate or poor.

    Overall ideal and poor concordance

    Researchers observed that within-couple concordance ranged from 53% (95% CI, 52-54) for cholesterol to 95% for diet (95% CI, 94-95).

    According to the study, for 79% of couples (95% CI, 78-80) both were in a nonideal category according to a CV health score based on the seven behaviors. This finding was predominately driven by unhealthy diet (94%; 95% CI, 93-94) and inadequate exercise (53%; 95% CI, 52-55).

    Among most couples, both members were in the ideal category for smoking status (60%; 95% CI, 59-61) and fasting glucose (56%; 95% CI, 55-58).

    With the exception of total cholesterol, when one member of a couple was in the ideal category of a Life’s Simple 7 parameter, their partner was more likely to be ideal in the same parameter, with ORs ranging from 1.3 for BP (95% CI, 1.1-1.5) to 10.6 for diet (95% CI, 7.4-15.3).

    “We found that within-couple concordance (ie, the percent of couples who were both in an ideal category or both in a nonideal category) was common (> 50%) for all Life’s Simple 7 factors as well as the CV health score. Behaviors that affect risk (smoking status, diet and physical activity) had particularly high concordance (> 69%), consistent with a previous study that investigated within-couple concordance of these behaviors,” the researchers wrote. “A total of 79% of the couples were in the nonideal category for the CV health score, a result associated with lifestyle behaviors.”

    A longer subanalysis

    Moreover, a 5-year longitudinal analysis of 2,186 couples found modest improvements changes in ideal BP concordance (55%; 95% CI, 53-57; to 59%; 95% CI, 57-61) and reductions in the prevalence of ideal fasting glucose (64%; 95% CI, 62-66; to 59%; 95% CI, 57-61).

    Investigators observed no change in any other factors.

    “It has also been shown that programs aimed at couples can be more effective in improving risk factors of the targeted individual compared with programs that target only the individual, perhaps because couple interventions benefit from the inherent social support provided to and by each member of the couple,” the researchers wrote. “Thus, since well-designed public health programs intended to promote healthy lifestyles could promote public health by improving CV risk factors and behaviors of both members of a couple as well as dependents in the same household, a potential effect that should be considered when evaluating the cost-effectiveness of public health programs.”

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