Positive changes in ideal CVH metrics reduce the incidence of stroke.

In 2010, the American Heart Association (AHA) released its 2020 Impact Goals for cardiovascular health (CVH) promotion and disease reduction1. The concept of ideal CVH is defined as the simultaneous presence of 4 ideal health behaviors (not smoking, having a normal body mass index [BMI], being physically active, and eating a healthy diet) and 3 ideal health factors (normal total cholesterol levels, blood pressure [BP], and fasting glucose levels). The presence of more ideal CVH metrics predicts a lower risk of cardiovascular disease (CVD), a lower risk of incident cancer and lower all-cause mortality2,3,4,5,6. Moreover, several studies have demonstrated the potentially combined protective impact of ideal CVH metrics on the incidence of stroke7,8,9,10. It is worthwhile to explore whether changes in health behaviors and factors affect the incidence of CVD and stroke. Recent studies have demonstrated that changes in ideal CVH status are associated with subclinical atherosclerosis and arterial stiffness, which are potential predictors of CVD and stroke11,12. Currently, little is known about how well changes in ideal CVH metrics in the follow-up predict the incidence of stroke. Therefore, the present study aim to explore the relationships among changes in ideal CVH metrics and the risk of stroke.