Comparative Discrimination of Life’s Simple 7 and Life’s Essential 8 to Stratify Cardiovascular Risk: Is the Added Complexity Worth It?
Key result
Life's Essential 8 shows no benefit over Life's Simple 7 for incident CVD discrimination.
- P=0.12
- n=11,609
Why the study?
Although Life's Essential 8 requires more information than Life's Simple 7, it was hypothesized to be a more reliable index of cardiovascular health.
Does the Life's Essential 8 metric improve discrimination of incident cardiovascular disease compared to Life's Simple 7 in adults free of baseline CVD?
Study Design
Type
Cohort (n=11,609)
Multicenter
Yes
Structured PICO
Does the Life's Essential 8 metric improve discrimination of incident cardiovascular disease compared to Life's Simple 7 in adults free of baseline CVD?
P
Population
11,609 Black and White participants free of baseline cardiovascular disease, followed for a median of 13 years.
E
Exposure
Life's Essential 8 (LE8) cardiovascular health metric
C
Comparator
Life's Simple 7 (LS7) cardiovascular health metric
O
Outcome
10-year risk of incident CVD (coronary heart disease or stroke) and discrimination quantified by difference in the c-statistichard clinical
Main Result
Absolute Event Rate: 0.695% vs 0.691%
p-value: p=0.12
The newer, more complex Life's Essential 8 metric does not significantly improve cardiovascular risk discrimination compared to the simpler Life's Simple 7 metric.
Authors
Discussion
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Implication
Similar LS7/LE8 discrimination for CVD; leaves open whether added sleep domain justifies LE8 complexity in practice or trials.
Cite This Study
Howard et al. (2023) conducted a cohort in Cardiovascular risk (n=11,609). Life's Essential 8 (LE8) vs. Life's Simple 7 (LS7) was evaluated on incident CVD discrimination (c-statistic) (p=0.12). Life's Essential 8 and Life's Simple 7 showed practically indistinguishable discrimination for incident CVD (c-statistic 0.695 vs 0.691; P=0.12).