February 28, 2015Open Access
View Full PaperAmerican Heart Association's Life's Simple 7 and Risk of Venous Thromboembolism: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Key Result
An optimal Life's Simple 7 cardiovascular health score was associated with a 44% lower risk of incident venous thromboembolism compared to an inadequate score (HR 0.56; 95% CI 0.38-0.82).
Study Design
Type
Cohort (n=30,239)
Multicenter
Yes
Structured PICO
Does a favorable Life's Simple 7 score reduce the risk of incident venous thromboembolism in adults ≥45 years of age?
P
Population
30,239 black and white adults aged ≥45 years across the United States, followed for 5.0 years to assess the association between Life's Simple 7 scores and incident VTE.
E
Exposure
Optimal (10 to 14 points) or average (5 to 9 points) Life's Simple 7 score
C
Comparator
Inadequate (0 to 4 points) Life's Simple 7 score
O
Outcome
Incident venous thromboembolism (VTE)hard clinical
Favorable cardiovascular health, as measured by the AHA's Life's Simple 7 metric, is associated with a significantly reduced risk of incident venous thromboembolism.
Main Result
Hazard Ratio: 0.56 (95% CI 0.38–0.82)
Absolute Event Rate: 1.8% vs 2.9%
Abstract
BACKGROUND: The 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 RESULTS: REGARDS 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. CONCLUSIONS: Life'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.