European Journal of Epidemiology

, Volume 32, Issue 1, pp 67–75 | Cite as

Leukocyte telomere length and ideal cardiovascular health in American Indians: the Strong Heart Family Study

  • Hao Peng
  • Mihriye Mete
  • Sameer Desale
  • Amanda M. Fretts
  • Shelley A. Cole
  • Lyle G. Best
  • Jue Lin
  • Elizabeth Blackburn
  • Elisa T. Lee
  • Barbara V. Howard
  • Jinying ZhaoEmail author


Telomere length, a marker of biological aging, has been associated with cardiovascular disease (CVD) and its risk factors. Ideal cardiovascular health (CVH), defined by the American Heart Association (AHA), has also been associated with a reduced risk of CVD, but the relationship between telomere length and ideal CVH is unclear. We measured leukocyte telomere length (LTL) by qPCR in 2568 American Indians in the Strong Heart Family Study (SHFS). All participants were free of overt CVD at enrollment (2001–2003). CVH indices included four behavioral factors (smoking, physical activity, diet, BMI) and three health factors (blood pressure, cholesterol, fasting glucose). Each index was categorized as poor, intermediate, or ideal according to the AHA’s guideline. CVH was further categorized into below average (0–1), average (2–3) and above average (≥4) based on the total number of ideal indices. Results showed that, 29, 50 and 21 % of study participants had below average, average, and above average CVH, respectively. Participants with above average CVH had significantly longer LTL than those with below average CVH (β = 0.034, P = 0.042) after adjusting for age, sex, education level, marital status, processed meat consumption, alcohol consumption, and study site. Compared to the U.S. general population, American Indians achieved lower rates for five out of the seven ideal CVH metrics, including smoking, BMI, physical activity, diet, and blood pressure. Achieving four or more ideal CVH metrics was significantly associated with longer LTL. This finding suggests that achieving an ideal CVH may prevent or delay CVD, probably through promoting healthy aging.


American Indians Biological aging Ideal cardiovascular health Leukocyte telomere length Strong heart family study 



The authors would also like to thank the Strong Heart Study participants, Indian Health Service facilities, and participating tribal communities for their extraordinary cooperation and involvement, which has contributed to the success of the Strong Heart Study. The views expressed in this article are those of the authors and do not necessarily reflect those of the Indian Health Service. This study was supported by NIH Grants R01DK091369, K01AG034259, R21HL092363 and cooperative agreement Grants U01HL65520, U01HL41642, U01HL41652, U01HL41654, and U01HL65521.

Compliance with ethical standards

Conflict of interest

:The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Hao Peng
    • 1
    • 2
  • Mihriye Mete
    • 3
  • Sameer Desale
    • 3
  • Amanda M. Fretts
    • 4
  • Shelley A. Cole
    • 5
  • Lyle G. Best
    • 6
  • Jue Lin
    • 7
  • Elizabeth Blackburn
    • 7
  • Elisa T. Lee
    • 8
  • Barbara V. Howard
    • 3
  • Jinying Zhao
    • 1
    • 2
    Email author
  1. 1.Department of Epidemiology, College of Public Health and Health Professions, College of MedicineUniversity of FloridaGainesvilleUSA
  2. 2.Department of EpidemiologyTulane University School of Public HealthNew OrleansUSA
  3. 3.MedStar Health Research InstituteHyattsvilleUSA
  4. 4.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  5. 5.Department of GeneticsTexas Biomedical Research InstituteSan AntonioUSA
  6. 6.Missouri Breaks Industries Research IncTimber LakeUSA
  7. 7.Department of Biochemistry and BiophysicsUniversity of CaliforniaSan FranciscoUSA
  8. 8.Center for American Indian Health ResearchUniversity of Oklahoma Health Science CenterOklahoma CityUSA

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