{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:07:07Z","timestamp":1774325227747,"version":"3.50.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2017,5,2]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>We examined the association of cardiovascular health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              The CHA study (Chicago Heart Association Detection Project in Industry) is a longitudinal cohort of employed men and women 18 to 74 years of age at baseline examination in 1967 to 1973. Baseline measurements included blood pressure, cholesterol, diabetes mellitus, body mass index, and smoking. Individuals were classified into 1 of 4 strata of cardiovascular health: favorable levels of all factors, 0 factors high but \u22651 elevated risk factors, 1 high risk factor, and \u22652 high risk factors. Linked Medicare and National Death Index data from 1984 to 2010 were used to determine morbidity in older age. An individual\u2019s all-cause morbidity score and cardiovascular morbidity score were calculated from\n              <jats:italic>International Classification of Disease, Ninth Revision<\/jats:italic>\n              codes for each year of follow-up.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              We included 25\u2009804 participants who became \u226565 years of age by 2010, representing 65% of all original CHA participants (43% female; 90% white; mean age, 44 years at baseline); 6% had favorable levels of all factors, 19% had \u22651 risk factors at elevated levels, 40% had 1 high risk factor, and 35% had \u22652 high risk factors. Favorable cardiovascular health at younger ages extended survival by almost 4 years and postponed the onset of all-cause and cardiovascular morbidity by 4.5 and 7 years, respectively, resulting in compression of morbidity in both absolute and relative terms. This translated to lower cumulative and annual healthcare costs for those in favorable cardiovascular health (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) during Medicare eligibility.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Individuals in favorable cardiovascular health in early middle age live a longer, healthier life free of all types of morbidity. These findings provide strong support for prevention efforts earlier in life aimed at preserving cardiovascular health and reducing the burden of disease in older ages.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.116.026252","type":"journal-article","created":{"date-parts":[[2017,5,1]],"date-time":"2017-05-01T20:15:31Z","timestamp":1493669731000},"page":"1693-1701","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":73,"title":["Favorable Cardiovascular Health, Compression of Morbidity, and Healthcare Costs"],"prefix":"10.1161","volume":"135","author":[{"given":"Norrina B.","family":"Allen","sequence":"first","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihui","family":"Zhao","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Liu","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Daviglus","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiang","family":"Liu","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Fries","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Chen Tina","family":"Shih","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Garside","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanh-Huyen","family":"Vu","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremiah","family":"Stamler","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald M.","family":"Lloyd-Jones","sequence":"additional","affiliation":[{"name":"From Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A., L.Z., L.L., K.L., T.-H.V., J.S., D.M.L.-J.); Institute of Minority Health Research, University of Illinois College of Medicine, Chicago (M.D., D.G.); Department of Medicine, Stanford School of Medicine, CA (J.F.); and Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston (Y.-C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31820a55f5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182285a81"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192703"},{"key":"e_1_3_3_5_2","first-page":"3","article-title":"U.S. Department of Health and Human Services: Office of Disease Prevention and Health Promotion\u2013Healthy People 2010","volume":"15","year":"2000","unstructured":"U.S. Department of Health and Human Services: Office of Disease Prevention and Health Promotion\u2013Healthy People 2010. 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