Introduction:
As part of its 2020 Impact Goals, the AHA developed the Life’s Simple 7 metric for cardiovascular health promotion. The metric consists of ideal categories for smoking, physical activity, diet, body mass index, blood pressure, blood cholesterol, and blood glucose; and its relationship with risk of chronic kidney disease (CKD) is unknown.
Hypothesis:
Ideal levels of health factors and the overall Life’s Simple 7 metric are associated with lower risk of developing CKD.
Methods:
We prospectively analyzed 15,436 Atherosclerosis Risk in Community study participants without CKD at baseline (1987-1989). Ideal levels of health factors were: non-smoker or quit >1 year ago; body mass index <25 kg/m
2
; ≥150 minutes/week of physical activity; dietary pattern which is high in fruits and vegetables, fish, and fiber-rich whole grains, and low in sodium and sugar-sweetened beverages; total cholesterol <200 mg/dL; blood pressure <120/90 mmHg; and blood glucose <100 mg/dL. Incident CKD was defined as development of estimated glomerular filtration rate <60 mL/min/1.73 m
2
accompanied by 25% decline from baseline, hospitalization or death due to CKD, or end-stage renal disease defined by linkage with the U.S. Renal Data System. Cox regression was used to estimate associations between health factors, the overall metric, and CKD risk while adjusting for age, sex, race, and baseline kidney function.
Results:
At baseline, mean age was 54 years, 55% were women, and 26% were African-American. There were 2,861 incident CKD cases over a median follow-up of 22 years. Smoking, body mass index, physical activity, blood pressure, and blood glucose were associated with lower CKD risk (all p≤0.01), but diet and blood cholesterol were not. CKD risk was inversely related to the number of ideal health factors (
Figure
; p-trend<0.001; AUC: 0.7001 vs. 0.6804, p<0.001).
Conclusions:
The AHA Life’s Simple 7 metric, developed to measure and promote cardiovascular health, predicts reduced CKD risk.
Association of lung function and chronic obstructive pulmonary disease with American Heart Association's Life's Simple 7 cardiovascular health metrics
