June 7, 2013Open Access
Life’s Simple 7 and Risk of Incident Stroke
Key Result
Each better health category of the Life's Simple 7 score was associated with a 25% lower risk of incident stroke (HR 0.75; 95% CI 0.63-0.90).
Study Design
Type
Cohort (n=22,914)
Multicenter
Yes
Structured PICO
Does a higher Life's Simple 7 score reduce the risk of incident stroke in adults without previous cardiovascular disease?
P
Population
22,914 black and white adults aged ≥45 years with no previous cardiovascular disease, followed for 4.9 years.
E
Exposure
Higher Life's Simple 7 (LS7) score (optimum or average cardiovascular health)
C
Comparator
Lower Life's Simple 7 (LS7) score (inadequate cardiovascular health)
O
Outcome
Incident stroke over 4.9 years of follow-uphard clinical
Better cardiovascular health, as measured by the Life's Simple 7 score, is associated with a significantly lower risk of incident stroke in both black and white Americans.
Main Result
Hazard Ratio: 0.75 (95% CI 0.63–0.9)
Abstract
BACKGROUND AND PURPOSE: The American Heart Association developed Life's Simple 7 (LS7) as a metric defining cardiovascular health. We investigated the association between LS7 and incident stroke in black and white Americans. METHODS: The Reasons for Geographic And Racial Differences in Stroke (REGARDS) is a national population-based cohort of 30 239 blacks and whites, aged ≥45 years, sampled from the US population from 2003 to 2007. Data were collected by telephone, self-administered questionnaires, and an in-home examination. Incident strokes were identified through biannual participant contact followed by adjudication of medical records. Levels of the LS7 components (blood pressure, cholesterol, glucose, body mass index, smoking, physical activity, and diet) were each coded as poor (0 point), intermediate (1 point), or ideal (2 points) health. An overall LS7 score was categorized as inadequate (0-4), average (5-9), or optimum (10-14) cardiovascular health. RESULTS: Among 22 914 subjects with LS7 data and no previous cardiovascular disease, there were 432 incident strokes over 4.9 years of follow-up. After adjusting for demographics, socioeconomic status, and region of residence, each better health category of the LS7 score was associated with a 25% lower risk of stroke (hazard ratios, 0.75; 95% confidence interval, 0.63-0.90). The association was similar for blacks and whites (interaction P value=0.55). A 1-point higher LS7 score was associated with an 8% lower risk of stroke (hazard ratios, 0.92; 95% confidence interval, 0.88-0.95). CONCLUSIONS: In both blacks and whites, better cardiovascular health, on the basis of the LS7 score, is associated with lower risk of stroke, and a small difference in scores was an important stroke determinant.