Background:
AHA's Life's Simple 7 cardiovascular health score is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT score (FBS) (blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T]), are also available. This study sought to compare the effectiveness of Life's Simple 7 and FBS in predicting the newly proposed 4-tiered LVH classification based on LV dilatation (high LV end-diastolic volume [EDV] index) and concentricity (mass/end-diastolic volume [M/EDV]
0.67
) in the general Chinese population.
Methods:
Participants from Northeast China Rural Cardiovascular Health study who underwent cardiac echocardiography (n=11,261) were enrolled. Patients with LVH were divided into 4 groups—eccentric nondilated (normal M/EDV and EDV), eccentric dilated (increased EDV, normal M/EDV), concentric nondilated (increased M/EDV, normal EDV), and concentric dilated (increased M/EDV and EDV)—and compared with patients with normal LVM.
Results:
With poor Life's Simple 7 and FBS as references, individuals with ideal Life's Simple 7 and FBS showed lower adjusted odds of having eccentric nondilated (Life's Simple 7, odds ratio [OR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.34 vs. FBS, OR: 0.28; 95% CI: 0.20 to 0.38), eccentric dilated (OR: 0.73 [0.57-0.94] vs. OR: 0.57 [0.43-0.76]), concentric nondilated (OR: 0.12 [0.04-0.38] vs. OR: 0.19 [0.07-0.52]), and concentric dilated LVH (OR: 0.12 [0.03-0.37] vs. OR: 0.26 [0.10-0.72]). Similar levels of significantly discriminating accuracy were found for Life's Simple 7 and FBS with respect to the eccentric nondilated (C-statistic: 0.737; 95% CI: 0.725 to 0.750 vs. 0.731; 95% CI: 0.718 to 0.744, respectively), eccentric dilated (0.684 [0.670-0.699] vs. 0.686 [0.671-0.701]), concentric nondilated (0.658 [0.624-0.692] vs. 0.650 [0.615-0.684]), and concentric dilated LVH (0.711 [0.678-0.744] vs. 0.698 [0.663-0.733]).
Conclusions:
Our findings demonstrate that the FBS appears capable of performing just as well as does the Life's Simple 7 in predicting the novel 4-group classification of LVH, making the FBS particularly suited as a reliable low-cost indicator of CV health in settings where access to laboratory analysis is limited and health care resources are constrained.
Usefulness of Left Ventricular Mass and Geometry for Determining 10-Year Prediction of Cardiovascular Disease in Adults Aged >65 Years (from the Cardiovascular Health Study)
