scholarly journals Life’s Simple 7 Cardiovascular Health Metrics and Progression of Coronary Artery Calcium in a Low-Risk Population

2019 ◽  
Vol 39 (4) ◽  
pp. 826-833 ◽  
Author(s):  
Seolhye Kim ◽  
Yoosoo Chang ◽  
Juhee Cho ◽  
Yun Soo Hong ◽  
Di Zhao ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiovascular Health ◽  
Subclinical Atherosclerosis ◽  
Heart Association ◽  
Healthy Adults ◽  
Inverse Association ◽  
Life Habits ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Objective— We examined the association of cardiovascular health (CVH) metrics with the development and progression of coronary artery calcium (CAC) among apparently healthy adults. Approach and Results— This cohort study included 65 494 men and women 30 years of age and older free of cardiovascular disease at baseline who underwent a comprehensive exam including CAC scoring. CVH metrics were defined according to the American Heart Association Life’s Simple 7 metrics based on smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. CVH scores range from 0 (all metrics considered unhealthy) to 7 (all metrics considered healthy). Participants were followed-up for a maximum of 6.6 years. Compared with participants with ideal CVH scores 0–1, the multivariable-adjusted difference in the change in geometric means of CAC scores over 5 years of follow-up were −0.40 (−0.62 to −0.19), −0.83 (−1.03 to −0.63), −1.06 (−1.25 to −0.86), −1.22 (−1.42 to −1.03), and −1.05 (−1.42 to −0.69) in participants with ideal CVH scores 2, 3, 4, 5, and 6–7, respectively. The inverse association between CVH scores and progression of CAC was observed both in participants with no CAC and in those with CAC detectable at baseline. Conclusions— A higher ideal CVH metrics score was strongly associated with a lower prevalence of CAC and with lower progression of CAC in males and females in a large cohort of healthy adults. Our findings suggest that maintaining a healthy life habits could help reduce the development and progression of subclinical atherosclerosis and ultimately prevent clinically cardiovascular event.

American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22–35-year-old adults conceived with and without assisted reproductive technologies

2019 ◽  
Vol 35 (1) ◽  
pp. 232-239 ◽  
Author(s):  
Markus Juonala ◽  
Sharon Lewis ◽  
Robert McLachlan ◽  
Karin Hammarberg ◽  
Joanne Kennedy ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Subclinical Atherosclerosis ◽  
Heart Association ◽  
Categorical Variables ◽  
Inverse Association ◽  
Health Score ◽  
Ideal Cardiovascular Health

Abstract STUDY QUESTION Is ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis? SUMMARY ANSWER The associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude. WHAT IS KNOWN ALREADY Long-term consequences of ART on cardiovascular health are unknown. STUDY DESIGN, SIZE, DURATION The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22–35 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always >0.2). AHA score was not associated with cIMT or retinal measures in either group (P always >0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) −0.18(−0.26 to −0.10)). A numerically similar relationship was observed in the smaller non-ART group (−0.19(−0.39 to 0.01)). LIMITATIONS, REASONS FOR CAUTION Even though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children’s Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.

Abstract MP28: Life’s Simple 7 and Incident Cognitive Impairment: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Evan L Thacker ◽  
Sarah R Gillett ◽  
Virginia G Wadley ◽  
Frederick W Unverzagt ◽  
Suzanne E Judd ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Lower Incidence ◽  
Cardiovascular Health ◽  
Cognitive Domain ◽  
Inverse Association ◽  
Southeastern Us ◽  
Race And Education ◽  
Life’S Simple 7 ◽  
Life's Simple 7 ◽  
Stroke Belt

HYPOTHESIS. We hypothesized that higher scores on Life’s Simple 7 (LS7), a composite measure of cardiovascular health, are associated with lower incidence of cognitive impairment in the absence of stroke, and that this association differs by race and geographic region. METHODS. We included REGARDS participants aged 45+ who at baseline were cognitively normal by the Six-Item Screener (SIS) and free of stroke. We censored participants at incident stroke. We calculated baseline LS7 score, ranging from 0 points (worst) to 14 points (best), from smoking, BMI, physical activity, diet, cholesterol, blood pressure, and fasting glucose. We defined incident cognitive impairment as (1) scoring ≤4 of 6 points on the most recent follow-up SIS, or (2) scoring ≥1.5 standard deviations below age, sex, race, and education-adjusted means on the most recent of at least 2 of 3 domain-specific cognitive tests. We calculated age, sex, race, and education-standardized percentages of participants with incident impairment by LS7 score tertiles, and age, sex, race, education, and region-adjusted odds ratios by tertiles and per 1 point higher LS7 score. We repeated analyses by race (black/white) and region (southeastern US stroke belt/nonbelt). RESULTS. The distribution of LS7 scores was higher in whites than blacks and outside the stroke belt than within the stroke belt. Incidence of cognitive impairment was lower at higher LS7 scores (Table). This inverse association was stronger for cognitive domain testing than for SIS. For SIS, we observed an inverse association among whites and outside the stroke belt, but not among blacks or within the stroke belt. For cognitive domain testing, the inverse association was similar across race and region. CONCLUSIONS. Favorable LS7 scores are associated with lower incidence of cognitive impairment, particularly as assessed by cognitive domain testing. Racial and regional differences in cardiovascular health and its association with cognitive impairment may contribute to cognitive impairment disparities.

Abstract P278: Life's Simple 7 and Risk of Incident Stroke in Black and White Americans: REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Ambar Kulshreshtha ◽  
Suzanne Judd ◽  
Viola Vaccarino ◽  
Virginia Howard ◽  
William McClellan ◽  
...  
Keyword(s):  
Racial Differences ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Cox Regression ◽  
Disease Incidence ◽  
Heart Association ◽  
P Value ◽  
Life’S Simple 7 ◽  
Blacks And Whites ◽  
Life's Simple 7

Background: The American Heart Association has developed Life’s Simple 7 (LS-7) as a measure of cardiovascular health. In a recent study, LS-7 showed a graded relationship with cardiovascular disease incidence. The association of LS-7 with incident stroke has not been reported previously. Methods: We analyzed data from REGARDS, a national population-based cohort of 30,239 blacks and whites, aged ≥ 45 years of age, sampled from US population between 2003 and 2007. Data for LS-7 was collected by telephone, mail questionnaires, and an in-home exam. Participants were contacted every 6 months for possible stroke, which was validated by physicians using medical record review. LS-7 components (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, diet) were each coded as: poor (1 point), intermediate (2 points) and ideal (3 points). An overall LS-7 score, created by summing the 7 component scores (possible range: 7 to 21), was categorized as: highest (17–21), medium (12–16) and lowest (7–11) cardiovascular health. Cox regression was used to model LS-7 score categories with stroke events. Results: There were 22,914 participants with data on LS-7 and no previous CVD. Mean age was 65 years, 40% were black, and 55% female. Over 4.9 years of follow-up, there were 432 incident strokes. Mean (SD) LS-7 score was 13.5 (2.5). After adjustment for age and sex, mean LS-7 scores were lower for blacks (12.9 ± 0.02) than whites (14.3 ± 0.02). LS-7 categories were associated with incident stroke in a graded fashion (figure). After adjusting for age, race, sex, income, and education, each better health category was associated with a 25% lower risk of incident stroke (HR=0.75, 95% CI = 0.63, 0.90). In stratified analyses, HR was similar for blacks and whites (p-value = 0.55). Conclusion: Blacks had lower levels of cardiovascular health factors than whites. Better cardiovascular health based on LS-7 score was associated with a lower risk of stroke. Results suggest that efforts to improve the LS-7 score may be useful for stroke prevention.

Abstract P386: Adult Height and Coronary Artery Calcium in the NHLBI Family Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Michael D Miedema ◽  
Andrew Petrone ◽  
James Pankow ◽  
Steven C Hunt ◽  
Aldi T Kraja ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Adult Height ◽  
Subclinical Atherosclerosis ◽  
P Value ◽  
Inverse Association ◽  
Odds Ratios ◽  
Family Heart Study ◽  
Heart Study ◽  
The Relationship

Introduction: Adult height is inversely associated with the risk of developing hypertension, hyperlipidemia, and diabetes. Height has also shown an inverse association with coronary heart disease and cardiovascular mortality, but the relationship between height and subclinical atherosclerosis is unclear. Coronary artery calcium (CAC) is a marker of atherosclerosis and a strong predictor of cardiovascular events. The relationship between height and CAC has not been well studied. Objective: To test the hypothesis that adult height is inversely associated with CAC. Methods: We studied 3,360 individuals from the National Heart, Lung, and Blood Institute Family Heart Study. Adult height was self-reported and CAC was measured by EBCT. We used generalized estimating equations to estimate adjusted prevalence odds ratios across quintiles of height. Results: Mean age of the sample was 54.9 years (SD +/- 12.9) and 57% were women. Baseline characteristics of the participants in sex-specific quintiles are shown in Table 1. After adjusting for age, the prevalence odds ratios for CAC decreased from the lowest quintile to the highest quintile (p-value for trend 0.02). After further adjustment for race, waist circumference, smoking, and field center, height remained inversely associated with CAC (adjusted odds ratios 1.0 [reference], 1.52 [1.13-2.05], 0.98 [0.75-1.28], 0.90 [0.68-1.20], 0.78 [0.58-1.03], p-value for trend <0.01). Additional adjustment for alcohol consumption, exercise, and total cholesterol did not materially change the strength of the association between height and CAC. No interaction was seen for gender or race. Conclusion: Adult height is inversely associated with the presence of CAC in middle-aged men and women.

scholarly journals The Association of Life’s Simple 7 with Aldosterone among African Americans in the Jackson Heart Study

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 955 ◽  
Author(s):  
Veena Kesireddy ◽  
Yubo Tan ◽  
David Kline ◽  
Guy Brock ◽  
James B. Odei ◽  
...  
Keyword(s):  
African Americans ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Jackson Heart Study ◽  
Ideal Cardiovascular Health ◽  
The Poor ◽  
Heart Study ◽  
Serum Aldosterone ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Background: Among African Americans (AAs), attaining higher levels of American Heart Association (AHA) ideal cardiovascular health (Life’s Simple 7 [LS7]) is associated with lower risk of diabetes and cardiovascular disease (CVD). We previously showed that aldosterone is associated with higher risk of diabetes and CVD in AAs. Thus, we investigated the association of LS7 metrics with aldosterone in the Jackson Heart Study (JHS). Methods: Ideal metrics were defined by AHA 2020 goals for health behaviors (smoking, dietary intake, physical activity, and body mass index) and health factors (total cholesterol, blood pressure, and fasting glucose). The number of ideal LS7 metrics attained at baseline were summed into a continuous score (0–7) and categorical groups (Poor: 0–1, Intermediate: 2–3, and Ideal: ≥4 ideal LS7 metrics). Multivariable linear regression was used. Results: Among 4,095 JHS participants (mean age 55 ± 13 years, 65% female), median serum aldosterone was 4.90, 4.30, and 3.70 ng/dL in the poor (n = 1132), intermediate (n = 2288) and ideal (n = 675) categories respectively. Aldosterone was 15% [0.85 (0.80, 0.90)] and 33% [0.67 (0.61, 0.75)] lower in the intermediate and ideal LS7 categories compared to the poor LS7 category. Each additional LS7 metric attained on continuous LS7 score (0–7) was associated with an 11% [0.89 (0.86, 0.91)] lower aldosterone level with variation by sex with women having a 15% lower aldosterone vs. 5% in men. Conclusions: Higher attainment of ideal LS7 metrics was associated with lower serum aldosterone among AAs with a greater magnitude of association among women compared to men.

scholarly journals Life's simple 7 (LSS) and its associations with coronary artery calcium (CAC): the Jackson Heart Study (JHS)

2013 ◽  
Vol 27 (S1) ◽  
Author(s):  
Sameera A Talegawkar ◽  
Ping Chen ◽  
Jiankang Liu ◽  
DeMarc A Hickson ◽  
Janice Maras ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Jackson Heart Study ◽  
Heart Study ◽  
Life’S Simple 7 ◽  
Life's Simple 7

scholarly journals Data from Digital Health Devices Informs Ideal Cardiovascular Health

2021 ◽  
Vol 11 (3) ◽  
pp. 189
Author(s):  
Jane A. Leopold ◽  
Roger B. Davis ◽  
Elliott M. Antman
Keyword(s):  
Cardiovascular Health ◽  
Digital Health ◽  
Vigorous Exercise ◽  
Activity Data ◽  
Health Score ◽  
Ideal Cardiovascular Health ◽  
Digital Devices ◽  
Significant Difference ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Ideal cardiovascular health is associated with a decrease in adverse cardiovascular events. The My Research Legacy study examined ideal cardiovascular health using the Life’s Simple 7 survey and data from digital health devices. We hypothesized that digital devices provide a more objective view of overall cardiovascular health status than self-reported measures. Therefore, we analyzed weight and activity data recorded by digital devices to recalculate the Life’s Simple 7 Health Score. All study participants (n = 1561) answered the survey, while a subgroup (n = 390) provided data from digital devices. Individuals with digital devices had a lower body mass index (BMI) and higher weekly minutes of vigorous exercise than participants without digital devices (p < 0.01). Baseline Health Scores were higher in individuals with digital devices compared to those without (7.0 ± 1.6 vs. 6.6 ± 1.6, p < 0.01). Data from digital devices reveal both increases and decreases in measured vs. self-reported BMI (p < 0.04) and weekly minutes of moderate and vigorous exercise activity (p < 0.01). Using these data, a significant difference was found between the recalculated and the self-reported Life’s Simple 7 Health Score (p < 0.05). These findings suggest that incorporation of digital health devices should be considered as part of a precision medicinal approach to assessing ideal cardiovascular health.

Abstract P104: Higher Leptin Levels Are Associated With Increased Odds Of Coronary Artery Calcium Progression: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Ct Scans ◽  
Agatston Score ◽  
Cvd Risk ◽  
Ethnic Study ◽  
History Of

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk

Abstract 13379: Cause-specific Mortality by Diffuse Coronary Artery Calcium Phenotypes: Results From the Coronary Artery Calcium Consortium

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ramzi Dudum ◽  
Zeina A Dardari ◽  
David Feldman ◽  
Daniel Berman ◽  
Matthew J Budoff ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Subclinical Atherosclerosis ◽  
Clinical Predictors ◽  
Specific Mortality ◽  
Risk Factor Data ◽  
Impact Risk ◽  
Traditional Risk Factors ◽  
Factor Data ◽  
Vessel Involvement

Objectives: We sought to assess characteristics of diffuse coronary artery calcium (CAC) phenotypes and their associations with cause-specific mortality. Background: CAC is a measure of subclinical atherosclerosis and improves risk stratification. CAC characteristics including vessel involvement, number of vessels, volume, and density have been shown to differentially impact risk. Less is known about clinical predictors of a diffuse CAC phenotype and its impact on cause-specific mortality. Methods: The CAC Consortium is a retrospective, multi-site cohort of 66,636 participants without CHD who underwent CAC scoring. Risk factor data were collected at enrollment or scan. Participants with CAC>0 were included—CAC area, CAC density, and the CAC index of diffusion (the percentage of total CAC in the vessel with the highest CAC score) were calculated and the association between CAC characteristics and CVD- and CHD-specific mortality was assessed. Results: In 28,147 study participants (mean age 58.3 years, 25% female, and 89.6% white), ~66% had ≥2 calcified vessels. Diabetes, hypertension, and hyperlipidemia were predictors of multivessel involvement (p<0.001). After controlling for CAC score, those with 4-vessel CAC had more CAC area involved with less dense calcification compared to those with 1-vessel involvement. After adjustment, those with CAC score 1-299 had a graded increase in CVD- and CHD-specific mortality with increasing vessel number compared with 1-vessel CAC. No difference was seen for individuals with CAC >300. Among those with multivessel CAC involvement, all-cause survival was significantly worse in diffuse compared to other phenotypes. Conclusion: Diffuse CAC involvement was characterized by less dense calcification, more CAC area, multiple coronary vessel involvement, and presence of certain traditional risk factors. Multivessel CAC is associated with increased CVD- and CHD-specific mortality, particularly among CAC scores 1-299.

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