Ideal cardiovascular health and cardiovascular-related events: a systematic review and meta-analysis

AIMS: The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs). METHODS AND RESULTS: EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias. Data were analysed with a random-effects meta-analysis. This meta-analysis included 59 studies (1 881 382 participants). Participants with ideal CVH had a considerably lower risk of a variety of CVDs and CMDs as compared with those with poor CVH, varying from 40% lower risk for atrial fibrillation (AF) hazard ratio HR = 0. 60 95% confidence interval (CI) 0. 44-0. 83 to 82% lower risk for myocardial infarction HR = 0. 18 (95% CI 0. 12-0. 28). Intermediate CVH was associated with 27-57% lower risk in CVDs and CMDs compared with poor CVH, with the highest hazard for AF HR = 0. 73 (95% CI 0. 59-0. 91) and the lowest hazard for peripheral arterial disease HR = 0. 43 (95% CI 0. 30-0. 60). CONCLUSION: Ideal and moderate CVH were associated with a lower incidence of CVDs and CMDs than poor CVH. Life Simple's 7 holds significant potential for promoting overall CVH and thereby contributing to the prevention of CVDs.