Vasan RS, Pan S, Larson MG, et al. - A substantially increased cardiovascular disease risk was conferred by the conjoint presence of atherosclerosis, arteriosclerosis, and poor cardiovascular health, whereas a low risk was observed in the absence of these 3 conditions.

• This is an analysis of the community-based Framingham Heart Study cohort (N=2,580, mean age 52 years, 49% women).

• Participants were divided on the basis of (1) the presence vs absence of coronary artery calcium; (2) higher (>sex-specific median) carotid-femoral pulse wave velocity; (3) poor cardiovascular health (score 0–7).

• In groups with 0 to 3 suboptimal measures, cardiovascular disease incidence rates/1,000 person-years were 1.93, 4.68, 8.93, and 18.26, respectively.

• Relative to the group with no abnormalities, the estimated corresponding multivariable-adjusted hazards ratios for cardiovascular disease were 1.81, 2.18, and 3.71, respectively.