Road to the American Heart Association 2020 Impact Goals
The Metric for Monitoring Progress
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In 2010, the Goals and Metric Committee of the Strategic Planning Task Force of the American Heart Association (AHA) developed the 2020 Impact Goals for the organization.1 The 2020 Impact Goal was to improve the cardiovascular health (CVH) of all Americans by 20% and reduce deaths from cardiovascular diseases (CVDs) and stroke by 20% by the year 2020.1 The Committee introduced a 7-item semiquantitative metric/concept of CVH and recommended its use for monitoring the changing prevalence of CVH status and defining achievement of the 2020 Impact Goals.
See Article by Hwang et al
Ideal CVH was defined by the presence of both ideal health behaviors (nonsmoking, body mass index <25 kg/m2, 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).1 Several studies have shown associations between this semiquantitative metric of CVH and cardiovascular outcomes or mortality.2–4 However, there are limited data showing that a change in this semiquantitative measure is associated with an appropriate change in cardiovascular outcomes, especially in low-risk populations.
Atherosclerosis is the underlying pathophysiology of most clinical cardiovascular outcomes.5 Atherosclerotic plaques can be calcified or noncalcified. Coronary artery calcium (CAC) score is a quantitative measure of calcified atherosclerotic plaque burden and has the strongest association and predictive value for future clinical cardiovascular outcomes and mortality among all measures of subclinical atherosclerosis.6,7 Thus, using CAC as an …