Objective To investigate associations of ideal cardiovascular health behaviors with arterial stiffness and its progression in adults for providing a reference to the prevention and treatment of cardiovascular diseases.

Methods A questionnaire survey, physical examination, laboratory tests, and brachial-ankle pulse wave velocity (baPWV) measurement were conducted among 5 536 adult physical examinees recruited through convenient sampling in a general hospital located in Wuhan city, Hubei province from August 2018 to May 2019. The evaluation of cardiovascular health behavior was performed using an integrated overall score that encompassed smoking, dietary pattern, exercise routine, body mass index (BMI), blood pressure, fasting plasma glucose, and total cholesterol level. Among the surveyed participants who had complete information and no history of cardiovascular disease at baseline (n = 2 683), a follow-up baPWV measurement was conducted approximately two years later from June 2019 to February 2022. From this follow-up group of individuals with valid data for both baPWV measurements and baseline values below or equal to 1400 cm/s (n = 372), an analysis was conducted to investigate factors influencing the progression of arterial stiffness. An unconditional multivariate logistic regression model was employed to explore the correlations between ideal cardiovascular health behaviors and arterial hardening as well as its progression.

Results Among the 2 683 individuals without a history of cardiovascular disease at baseline survey, 34.03%, 48.16%, and 17.81% were assessed as having ideal, general, and poor cardiovascular health behaviors or factors respectively, while 31.83% were detected with arterial stiffness indicated by baPWV ≥ 1 400 cm/s. In contrast, among the 372 individuals with the two baPWV measurements and without baseline arterial stiffness (baPWV < 1 400 cm/s), the proportions of having ideal, general, and poor cardiovascular health behaviors were 43.55%, 42.74%, and 13.71% respectively; meanwhile, progressive arterial stiffness was observed in approximately one-fifth of them according to elevated baPWV values (≥ 1 400 cm/s). After adjusting for confounding factors such as gender, age, education level and family history of cardiovascular disease using multivariate logistic regression analysis method, the results showed that compared to those with poor cardiovascular health behavior or factors, individuals who had ideal or general cardiovascular health behavior had significantly decreased risk of developing arterial stiffness with odds ratios (OR) being equal to 0.28 (95% confidence interval 95%CI: 0.21 – 0.37) and 0.64(95%CI: 0.51 – 0.81), respectively. Further adjustment for baseline baPWV values revealed that the risk of progressive arterial stiffness significantly decreased (OR = 0.29, 95%CI: 0.11 – 0.73) in individuals who had ideal rather than poor cardiovascular health behaviors.

Conclusion The ideal cardiovascular health behavior and factor scores exhibit a significant negative correlation with the occurrence and progression of arterial stiffness among Chinese adults. Moreover, early intervention aimed at promoting ideal cardiovascular health behavior and factors has the potential to effectively delay the onset and development of arterial stiffness.