index, physical activity, healthy diet, and smoking) was given a point score of 0, 1, ..... Modified for Emory Twin Study and based on tertiles of DASH diet score.
ORIGINAL RESEARCH
Association Between Ideal Cardiovascular Health and Carotid Intima-Media Thickness: A Twin Study Ambar Kulshreshtha, MD, PhD; Abhinav Goyal, MD, MHS; Emir Veledar, PhD; William McClellan, MD, MPH; Suzanne Judd, PhD; Silvia C. Eufinger, MPH, PhD; J. Douglas Bremner, MD; Jack Goldberg, PhD; Viola Vaccarino, MD, PhD
Background-—The American Heart Association (AHA) recently developed the Cardiovascular Health Index (CVHI), a health metric consisting of 7 modifiable risk factors. The relationship of the CVHI with preclinical markers, such as carotid intima-media thickness (CIMT) has not been assessed. Methods-—We examined 490 male monozygotic and dizygotic twins without overt cardiovascular disease. CIMT was measured using B-mode ultrasonography. Each of the 7 CVHI components (blood pressure, fasting glucose, total cholesterol, body mass index, physical activity, healthy diet, and smoking) was given a point score of 0, 1, or 2 to represent poor, intermediate, or ideal health, respectively. A CVHI summation score was computed (range 0 to 14) and categorized as inadequate (0 to 4), average (5 to 9), or optimum (10 to 14) cardiovascular health. Mixed-model regression was used to examine the association of the CVHI with CIMT. Results-—The mean age of the twins was 55.4 years, and 61% were monozygotic. The mean CIMT was 0.75 (0.11) mm and the mean CVHI score was 7.7 (2.1). There was an inverse correlation between CVHI and CIMT (Spearman r= 0.22, P
