Table 3.

Adjusted Hazard Ratio and Population-Attributable Faction of Cardiovascular Health Metrics and Risk of All-Cause Mortality—NHANES III Linked Mortality File

Cardiovascular Health Metrica	Cases/Participants	HR (95% CI)		Adjusted PAF (95% CI)c
		Age-, Sex-, and Race/Ethnicity–Adjusted	Fully Adjustedb
Current smoking
Yes	691/3542	1 [Reference]	1 [Reference]
No	1982/9770	0.46 (0.40–0.52)	0.49 (0.42–0.57)	24.5 (17.9–30.9)
Physical activity
No	1722/8316	1 [Reference]	1 [Reference]
Yes	951/4996	0.79 (0.74–0.86)	0.85 (0.77–0.93)	10.9 (3.0–18.7)
BMId
≥25	1678/8160	1 [Reference]	1 [Reference]
<25	995/5152	1.04 (0.93–1.16)	1.04 (0.93–1.17)	NA
Healthy diet score
<2 components	1919/10 245	1 [Reference]	1 [Reference]
≥2 components	754/3067	0.83 (0.73–0.95)	0.94 (0.83–1.07)	1.8 (0.0–15.2)
Total serum cholesterol, mg/dL
≥200	1669/6831	1 [Reference]	1 [Reference]
<200 (untreated)	1004/6481	1.23 (1.11–1.37)	1.28 (1.15–1.42)	NA
Blood pressure, mm Hg
≥120/≥80	2297/7947	1 [Reference]	1 [Reference]
<120/<80 (untreated)	376/5365	0.79 (0.66–0.94)	0.81 (0.68–0.95)	30.4 (19.4–40.6)
HbA1c, %e
≥5.7	1144/3233	1 [Reference]	1 [Reference]
<5.7	1529/10 079	0.69 (0.63–0.75)	0.73 (0.67–0.80)	10.5 (6.2–14.7)

Abbreviations: BMI, body mass index; CVD, cardiovascular disease; HbA_1c, glycated hemoglobin; HR, hazard ratio; IHD, ischemic heart disease; NA, not available; NHANES, National Health and Nutrition Examination Survey; PAF, population-attributable fraction.

SI conversion factors: To convert total cholesterol values to mmol/L, multiply by 0.0259.

^aEach cardiovascular health metric was dichotomized by the ideal category of American Heart Association definitions, with the exceptions of the healthy diet score and smoking: (never and former smoking vs current smoking); (ideal physical activity vs others) + (BMI <25 vs others) + (healthy diet score ≥2 vs <2 components) + (total cholesterol <200 mg/dL untreated vs others) + (blood pressure <120/<80 mm Hg untreated vs others) + (HbA_1c <5.7% vs others).

^bAdjusted for age, sex, race/ethnicity, educational attainment, alcohol intake, family history of CVD, smoking status, physical activity, BMI, healthy diet score, total cholesterol level, blood pressure, and HbA_1cvalue.

^cAdjusted for age, sex, race/ethnicity, educational attainment, alcohol intake, family history of CVD, smoking status, physical activity, BMI, healthy diet score, total cholesterol level, blood pressure, and HbA_1c value. Sum of individual PAFs can sum to more than the overall PAF (Table 3), because some individuals with more than 1 risk factor could have cardiovascular disease deaths postponed in more than 1 way, and the postponed deaths of these individuals could be counted more than once. The individual PAFs cannot be calculated for the cardiovascular health metrics with adjusted HRs of 1.0 or greater (eg, BMI or total cholesterol level), and the negative values of the lower 95% CI of the PAF were rounded to zero.

^dCalculated as weight in kilograms divided by height in meters squared.

^eAn HbA_1c value less than 5.7% was used as a proxy for a fasting glucose level less than 100 mg/dL.