American Heart Association's Life's Simple 7 and Risk of Venous Thromboembolism: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Abstract

BackgroundThe American Heart Association's Life's Simple 7 metric is being used to track the population's cardiovascular health (CVH) toward a 2020 goal for improvement. The metric includes body mass index (BMI), blood pressure, cholesterol, glucose, physical activity (PA), cigarette smoking, and diet. We hypothesized a lower risk of venous thromboembolism (VTE) with favorable Life's Simple 7 scores.Methods and ResultsREGARDS recruited 30 239 black and white participants ≥45 years of age across the United States in 2003–2007. A 14‐point summary score for Life's Simple 7 classified participants into inadequate (0 to 4 points), average (5 to 9 points), and optimal (10 to 14 points) categories. Hazard ratios (HRs) of incident VTE were calculated for these categories, adjusting for age, sex, race, income, education, and region of residence. For comparison, HRs of VTE were calculated using the Framingham 10‐year coronary risk score. There were 263 incident VTE cases over 5.0 years of follow‐up; incidence rates per 1000 person‐years declined from 2.9 (95% confidence interval [CI], 2.3 to 3.7) among those in the inadequate category to 1.8 (95% CI, 1.4 to 2.4) in the optimal category. Compared to the inadequate category, participants in the average category had a 38% lower VTE risk (95% CI, 11 to 57) and participants in the optimal category had a 44% lower risk (95% CI, 18 to 62). The individual score components related to lower VTE risk were ideal PA and BMI. There was no association of Framingham Score with VTE.ConclusionsLife's Simple 7, a CVH metric, was associated with reduced VTE risk. Findings suggest that efforts to improve the population's CVH may reduce VTE incidence.

American Heart Association's Life's Simple 7 at Middle Age and Prognosis After Myocardial Infarction in Later Life

“…For dietary patterns in Life's Simple 7, some investigators raised a concern that adherence to the 5 AHA dietary recommendations is challenging 25. In fact, in our study as well as previous ones, the prevalence of ideal diet patterns is low (<1%–6%) 17, 18, 26, 27, 28. This might partially explain no significant association, even with incident MI, an analysis with much higher statistical power than the analysis after incident MI.…”

“…Baseline characteristics are presented as means and SDs for continuous variables and proportions for categorical variables across categories of Life's Simple 7 summary score of 0 to 3, 4 to 6, 7 to 9, and ≥10 17, 18…”

Cardiovascular Health and Incident Hypertension in Blacks

“…9, 11, 28–33 Among 3,107 African American participants of the ARIC study who were followed for a median 18.7 years, the age-sex adjusted CVD incidence rates per 1,000 person years (95% CI) for participants with 0, 1, 2, 3, 4 and ≥5 ideal Life’s Simple 7 components were 40.4 (32.0–51.5), 25.3 (22.4–28.6), 16.9 (15.0–19.1), 14.2 (12.2–16.5), 8.7 (6.6–11.5) and 3.3 (1.5–7.4), respectively. 29 Having more Life’s Simple 7 components in the ideal range has also been associated with a lower risk for incident cognitive impairment 34, 35 , venous thromboembolism 36 , vascular and non-vascular death, 28 end-stage renal disease 37 and CKD 38 in African Americans.…”

Overall Cardiovascular Health Is Associated With All-Cause and Cardiovascular Disease Mortality Among Older Community-Dwelling Men and Women

“…Several studies have demonstrated a protective association for higher scores for this summary measure with CVD, including stroke and coronary heart disease (Folsom et al, 2011; Kulshreshtha et al, 2013). And evidence for protective associations have also been reported for other health conditions including chronic kidney disease, venous thromboembolism, subclinical atherosclerosis, inflammation, cognitive decline, and depression (Kronish, Carson, Davidson, Muntner, & Safford, 2012; Muntner et al, 2013; Olson et al, 2015; Thacker et al, 2014; Xanthakis et al, 2014) It is important to note that most of these studies have examined the role of cardiovascular health in young and middle-aged adults, and there are few investigations that have focused on older populations.…”