scholarly journals National Trends in American Heart Association Revised Life's Simple 7 Metrics Associated With Risk of Mortality Among US Adults

2019 ◽  
Vol 2 (10) ◽  
pp. e1913131 ◽  
Author(s):  
Liyuan Han ◽  
Dingyun You ◽  
Wenjie Ma ◽  
Thomas Astell-Burt ◽  
Xiaoqi Feng ◽  
...  
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L M Ruilope ◽  
E Calvo-Bonacho ◽  
L Quevedo-Aguado ◽  
C Catalina-Romero ◽  
P Valdivielso ◽  
...  

Abstract Background/Introduction Practice guidelines are agreed on the importance of lifestyle advice for cardiovascular risk reduction as well as cardiovascular risk prediction in planning preventive strategies. Purpose To assess the clinical usefulness of the application of the predictive model of cardiovascular risk (CVR) IberScore combined with the recommendations of “Life's Simple 7” (LS7) of the American Heart Association (AHA) in a working population. Methods IberScore model is a predictive function for fatal and non-fatal cardiovascular (CV) events derived from a cohort of 774,404 workers (70.4% of the target population) between 16–65 years (average of 35.7 (SD = 10.7)) without CV disease at admission, which was followed for a period of 10 years. Age, sex, total cholesterol, HDL, SBP, glycemia, obesity and a history of dyslipidemia, hypertension and diabetes were used as factors of CVR. Using this model, patients were classified into 4 risk levels. It was also assessed the ideal health status according to the recommendations of “Life's Simple 7” (which includes healthy diet, physical activity, smoking cessation, BMI <25 kg/m2, total cholesterol without treatment <200mg/dl, blood pressure without treatment <120/80 mmHg and basal glycemia <100 mg/dl). Finally, these classifications were compared with the appearance of CV events in a 10-year follow-up. Results The results showed a high sensitivity (given that the predictive capacity reached 82% of the cardiovascular events) by using the IberScore, a logistic flexible parametric model to predict 10-year cardiovascular risk. Likewise, the clinical usefulness of the “Life's Simple 7” recommendations could be verified in order to reduce the incidence of total CV events (fatal and non-fatal). Conclusions The integration of the predictive model IberScore with the preventive recommendations “Life's simple 7” of the AHA applied to the working population would allow a more efficient cardiovascular prevention. Acknowledgement/Funding This project received a research grant from the Carlos III Health Institute (Ministry of Science, Innovation and Universities, Spain). Ref. PI18/01809


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Chris Calitz ◽  
Kristin Pham ◽  
Adela Santana ◽  
Eduardo Sanchez ◽  
Ross Arena ◽  
...  

Background: Comprehensive workplace wellness programs (CWWPs) have the potential to improve the heart health of the US workforce. To accelerate the adoption of these programs, the American Heart Association launched the Workplace Health Achievement Index (WHAI). The WHAI is an online scorecard that evaluates a workplace’s culture of health and the aggregate heart health score of its workforce as measured by Life’s Simple 7. Evidence from other workplace scorecards indicate that smaller companies achieve lower scores. Objective: To quantify differences in WHAI scores and score components between smaller (<250 employees) and larger (250+ employees) worksites. Methods: The total WHAI score is derived from 55 structure and process measures across seven best-practice domains and performance metrics based on employee Life’s Simple 7 data. Data from the first WHAI cycle (Feb 1 - June 30, 2016) were analyzed from 239 worksites that provided structure and process information. All data were stratified according to company size (smaller vs. larger). Differences in practice and performance measures were assessed across groups using Pearson chi-square tests or paired t-tests. Results: Overall, 5% of workplaces submitted the required amount of heart health metrics data (≥25% of employees) for eligibility. Smaller companies achieved a lower total WHAI score and lower scores across all domains except for Partnerships (Table 1). Conclusion: Lower WHAI scores for smaller companies may be due to limited resources and capacity to implement CWWPs. Low submission of performance metrics highlights the challenge of including these data in a comprehensive assessment of CWWPs. To meet its 2020 Goals, AHA should consider providing smaller companies with resources to implement CWWPs and develop strategies to increase submission of employee Life’s Simple 7 data. Table 1: Differences in mean AHA Index scores between small and large companies *Sample sizes too small for meaningful comparison.


2003 ◽  
Vol 22 (05) ◽  
pp. 222-232
Author(s):  
H.-H. Eckstein

ZusammenfassungNach Durchführung prospektiv-randomisierter Studien liegen für die Karotis-Thrombendarteriektomie (KarotisTEA) höhergradiger Karotisstenosen gesicherte Indikationen auf dem Evidenzlevel Ia mit dem Empfehlungsgrad A vor. Dies betrifft sowohl >50%ige symptomatische als auch >60%ige asymptomatische Stenosen (NASCET-Kriterien). In Subgruppen-Analysen aus NASCET konnten klinische und morphologische Variablen identifiziert werden, die auf ein besonders hohes Risiko eines karotisbedingten Schlaganfalls im natürlichen Verlauf hinweisen. Patienten mit folgenden Variablen profitieren daher besonders von der Karotis-TEA: Stenosegrad >90%, schlechter Kollateralkreislauf, kontralateraler Karotisverschluss, Plaque-Ulzerationen, Tandemstenosen, intraluminale Thromben, nicht-lakunärer Hirninfarkt, Lebensalter >75 Jahre, komplexes klinisches Risikoprofil, Hemisphären-TIA (vs. Amaurosis fugax), männliches Geschlecht. Der präventive Effekt der Karotis-TEA kann jedoch nur unter Beachtung eines niedrigen perioperativen Schlaganfallbzw. Letalitätrisikos realisiert werden. Nach Empfehlungen der American Heart Association (AHA) darf das perioperative Risiko 3% bei asymptomatischen Stenosen ohne kontralaterale Stenose, 5% bei asymptomatischen Stenosen mit hochgradiger kontralateraler Stenose oder Verschluss und 6% bei symptomatischen >50%ige Stenosen (NASCET-Kriterien) nicht überschreiten. Die Ergebnisse der Qualitätssicherung Karotis-TEA der Deutschen Gesellschaft für Gefäßchirurgie (DGG) zeigen, dass diese maximal akzeptablen Obergrenzen zum Teil deutlich unterschritten werden. Vor diesem Hintergrund stellt das Stenting von Karotisstenosen einen klinischen Heilversuch dar, der nur nach interdisziplinärem Konsil und/oder i. R. randomisierter Studien zulässig ist.


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