In 2010, the American Heart Association (AHA) launched the groundbreaking
Life’s Simple 7™
campaign to improve the cardiovascular health (CVH) of Americans. Five of the 7 [smoking, body mass index (BMI), blood pressure, cholesterol, and glucose] are commonly recorded in electronic medical records (EMRs). Although CVH components are often included in patient-provider discussions, to date there has been no formal attempt to characterize CVH from EMR data. We characterized the CVH of 160 female patients ages 65 and older seen in an Ohio State University primary care clinic from May 1 through July 31, 2013. We defined CVH according to AHA criteria, and assigned each behavior and factor to either an “ideal”, “intermediate”, or “poor” category. We calculated an overall CVH score ranging from 0 (worst) to 10 (best) by summing across behaviors and factors as follows: poor, 0; intermediate, 1; and ideal, 2. We calculated means and standard deviations (sd) of continuous variables and report frequencies within CVH categories. Patients were an average of 74.2 (sd=6.7) years old, and 35% were black. Among the 126 (79%) women who had data available on all 5 factors, mean CVH score was 6.0 (sd=1.3). Among all women, the mean fractional score (actual score/maximum possible) was 0.63 (sd=0.14), and it did not differ significantly by race. Greater than 10% of data were missing for BMI (13%) and cholesterol (11%).
Figure 1
shows the distribution of ideal, intermediate, poor, and missing CVH values for each behavior and factor. We have demonstrated that a majority of
Life’s Simple 7™
components are easily queried from EMRs. These data indicate that older female patients seen in the primary care setting have less-than-ideal CVH. There exists great potential to leverage the EMR for patient-provider communication and engagement around CVH. As such, we are implementing an automated assessment of CVH targeted to primary care providers and their older female patients. Following the intervention, CVH values will be compared to these baseline data.
Figure 1. Percent of older female patients (n=160) who were seen in a primary care clinic by category of CVH: behaviors and factors*.
*Diabetes was defined as either treated by a glucose-lowering medication (intermediate) or not (ideal), since over 90% of data were missing for fasting glucose or hemoglobin A1c.
Associations of weight cycling with cardiovascular health using American Heart Association’s Life’s Simple 7 in a diverse sample of women
