Ideal cardiovascular health and the prevalence and progression of coronary artery calcification in adults with and without type 1 diabetes

  1. Janet K. Snell-Bergeon, PhD, MPH
  1. *Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
  2. Barbara Davis Center, University of Colorado Denver, Aurora, CO
  1. Corresponding Author: Amy C. Alman, Email: aalman{at}


Objective In 2010, the American Heart Association defined 7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose) for ideal cardiovascular health (ICH). Subsequent studies have shown that the prevalence of achieving these metrics is very low in the general population. Adults with type 1 diabetes are at increased risk of cardiovascular disease, but no studies to date have been published on the prevalence of ICH in this population.

Research Design and Methods Data for this analysis were collected as part of the prospective Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study. This analysis involved 546 subjects with type 1 diabetes and 631 subjects without diabetes who had complete information for calculating the ICH metrics.

Results Overall, the prevalence of ICH was low in this population, with none meeting the ideal criteria for all 7 metrics. The prevalence of ideal physical activity (10.0%) and diet (1.1%) were particularly low. ICH was significantly associated with both decreased prevalence (OR 0.70; 95% CI 0.62-0.80) and progression (OR 0.77; 95% CI 0.66-0.90) of coronary artery calcification.

Conclusions ICH is significantly associated with decreased prevalence and progression of coronary artery calcification, however, prevalence of ICH metrics was low in both adults with and without type 1 diabetes. Efforts to increase the prevalence of ICH could have a significant impact on reducing the burden of cardiovascular disease.

  • Received June 8, 2013.
  • Accepted October 6, 2013.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details.