Less Than Ideal Cardiovascular Health Is Associated With Shorter Leukocyte Telomere Length: The National Health and Nutrition Examination Surveys, 1999-2002.
BACKGROUND
The associations between individual cardiovascular disease risk factors and leukocyte telomere length (LTL) have been inconclusive. We investigated the association between LTL and overall cardiovascular health (CVH) as defined by the American Heart Association and whether the association is modified by sex and race/ethnicity.


METHODS AND RESULTS
We included 5194 adults (aged ≥20) from the National Health and Nutrition Examination Survey 1999-2002. CVH was defined as a composite score of the 7 metrics (smoking, physical activity, diet, body mass index, blood pressure, total cholesterol, and fasting blood glucose) and categorized as "poor," "intermediate," and "ideal." LTL was assayed from whole blood using the quantitative polymerase chain reaction method relative to standard reference DNA. Multivariable linear regression models were used to estimate the association between CVH and log-transformed LTL. We found strong graded association between CVH and LTL in the overall sample, with evidence of dose-response relationship (P for trend=0.013). Individuals with poor and intermediate CVH had significantly shorter LTL than individuals with ideal CVH (-3.4% [95% CI=-6.0%, -0.8%] and -2.4% [-4.4%, -0.3%], respectively), after adjustment for demographic variables, socioeconomic status, and C-reactive protein. The association was stronger in women (-6.6% [-10.2%, -2.9%] for poor vs ideal CVH) and non-Hispanic whites (-4.3% [-7.1%, -1.4%] for poor vs ideal CVH).


CONCLUSIONS
The findings suggest that less-than-ideal CVH is associated with shorter LTL, but this association varies by sex and race/ethnicity. Future longitudinal research is needed to elucidate the mechanisms that underlie the association between CVH and LTL.
['Gebreab|Samson Y|SY|', 'Manna|Zerai G|ZG|', 'Khan|Rumana J|RJ|', 'Riestra|Pia|P|', 'Xu|Ruihua|R|', 'Davis|Sharon K|SK|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002318:Cardiovascular Diseases D003430:Cross-Sectional Studies D005006:Ethnicity D015444:Exercise D005260:Female D005500:Follow-Up Studies D006304:Health Status D006801:Humans D007962:Leukocytes D008297:Male D008875:Middle Aged D009017:Morbidity D009749:Nutrition Surveys D015995:Prevalence D012189:Retrospective Studies D012307:Risk Factors D012923:Social Class D016615:Telomere D013997:Time Factors D014481:United States D055815:Young Adult
cardiovascular health leukocyte telomere length cardiovascular disease risk factors aging AHA Scientific Statement diverse populations epidemiology inflammation telomere genetics