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American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.

ABSTRACT: BACKGROUND:Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association's Life's Simple 7 guidelines—on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose—is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age. METHODS:We studied the population-based Atherosclerosis Risk in Communities Study cohort of 13,462 adults ages 45-64 years in 1987-1989. From the 1987-1989 risk factor measurements, we created a Life's Simple 7 score (range 0-14, giving 2 points for ideal, 1 point for intermediate, and 0 points for poor components). We identified 2218 incident heart failure events using surveillance of hospital discharge and death codes through 2011. In addition, in 4855 participants free of clinical cardiovascular disease in 2011-2013, we performed echocardiography from which we quantified left ventricular hypertrophy and diastolic dysfunction. RESULTS:One in four participants (25.5%) developed heart failure through age 85 years. Yet, this lifetime heart failure risk was 14.4% for those with a middle-age Life's Simple 7 score of 10-14 (optimal), 26.8% for a score of 5-9 (average), and 48.6% for a score of 0-4 (inadequate). Among those with no clinical cardiovascular event, the prevalence of left ventricular hypertrophy in late life was approximately 40% as common, and diastolic dysfunction was approximately 60% as common, among those with an optimal middle-age Life's Simple 7 score, compared with an inadequate score. CONCLUSIONS:Greater achievement of American Heart Association's Life's Simple 7 in middle age is associated with a lower lifetime occurrence of heart failure and greater preservation of cardiac structure and function.

SUBMITTER: Folsom AR

PROVIDER: S-EPMC4554769 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.

Folsom Aaron R AR Shah Amil M AM Lutsey Pamela L PL Roetker Nicholas S NS Alonso Alvaro A Avery Christy L CL Miedema Michael D MD Konety Suma S Chang Patricia P PP Solomon Scott D SD

The American journal of medicine 20150420 9

<h4>Background</h4>Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association's Life's Simple 7 guidelines—on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose—is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age.<h4>Methods</h4>We studied the population-based Atherosclerosis Risk in C ...[more]

PMID: 25908393

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Project description:BackgroundUnderstanding the effect of lifestyle and genetic risk on the lifetime risk of coronary heart disease (CHD) is important to improving public health initiatives. Our objective was to quantify remaining lifetime risk and years free of CHD according to polygenic risk and the American Heart Association's Life's Simple 7 (LS7) guidelines in a population-based cohort study.MethodsOur analysis included data from participants of the ARIC (Atherosclerosis Risk in Communities) study: 8372 White and 2314 Black participants; 45 years of age and older; and free of CHD at baseline examination. A polygenic risk score (PRS) comprised more than 6 million genetic variants was categorized into low (<20th percentile), intermediate, and high (>80th percentile). An overall LS7 score was calculated at baseline and categorized into "poor," "intermediate," and "ideal" cardiovascular health. Lifetime risk and CHD-free years were computed according to polygenic risk and LS7 categories.ResultsThe overall remaining lifetime risk was 27%, ranging from 16.6% in individuals with an ideal LS7 score to 43.1% for individuals with a poor LS7 score. The association of PRS with lifetime risk differed according to ancestry. In White participants, remaining lifetime risk ranged from 19.8% to 39.3% according to increasing PRS categories. Individuals with a high PRS and poor LS7 had a remaining lifetime risk of 67.1% and 15.9 fewer CHD-free years than did those with intermediate polygenic risk and LS7 scores. In the high-PRS group, ideal LS7 was associated with 20.2 more CHD-free years compared with poor LS7. In Black participants, remaining lifetime risk ranged from 19.1% to 28.6% according to increasing PRS category. Similar lifetime risk estimates were observed for individuals of poor LS7 regardless of PRS category. In the high-PRS group, an ideal LS7 score was associated with only 4.5 more CHD-free years compared with a poor LS7 score.ConclusionsIdeal adherence to LS7 recommendations was associated with lower lifetime risk of CHD for all individuals, especially in those with high genetic susceptibility. In Black participants, adherence to LS7 guidelines contributed to lifetime risk of CHD more so than current PRSs. Improved PRSs are needed to properly evaluate genetic susceptibility for CHD in diverse populations.

Project description:ObjectiveAfrican-Americans have a strikingly low prevalence of ideal cardiovascular health metrics of the American Heart Association's Life's Simple 7 (LS7). This study was conducted to assess the impact of a community-based cardiovascular disease prevention intervention on the knowledge and achievement of cardiovascular health metrics among a marginalized African-American community.MethodsAdult congregants (n = 37, 70 % women) from three African-American churches in Rochester, MN, participated in the Fostering African-American Improvement in Total Health (FAITH!) program, a theory-based, culturally-tailored, 16-week education series incorporating the American Heart Association's LS7 framework. Feasibility testing included assessments of participant recruitment, program attendance, and retention. We classified participants according to definitions of ideal, intermediate, and poor cardiovascular health based on cardiac risk factors and health behaviors and calculated an LS7 score (range 0 to 14) at baseline and post-intervention. Knowledge of cardiac risk factors was assessed by questionnaire. Main outcome measures were changes in cardiovascular health knowledge and cardiovascular health components related to LS7 from baseline to post-intervention. Psychosocial measures included socioeconomic status, outlook on life, self-reported health, self-efficacy, and family support.ResultsThirty-six out of 37 recruited participants completed the entire program including health assessments. Participants attended 63.5 % of the education series and attendance at each session was, on average, 62 % of those enrolled. There was a statistically significant improvement in cardiovascular health knowledge (p < 0.02). A higher percentage of participants meeting either ideal or intermediate LS7 score categories and a lower percentage within the poor category were observed. Higher LS7 scores correlated with higher psychosocial measures ratings.ConclusionsAlthough small, our study suggests that the FAITH! program is a feasible, community intervention promoting ideal cardiovascular health that has the potential to improve cardiovascular health literacy and LS7 among African-Americans.

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American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.

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American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.

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