Abstract P016: Association Between Life’S Simple 7 Score And Cognitive Status In Older Adults With Atrial Fibrillation

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Eric Y Ding ◽  
Weijia Wang ◽  
Darleen Lessard ◽  
Jordy Mehawej ◽  
Tanya Mailhot ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Cardiovascular Health ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Systematic Assessment ◽  
Sample Average ◽  
Life’S Simple 7 ◽  
Life's Simple 7 ◽  
Reported Data

Introduction: The American Heart Association’s Life’s Simple 7 (LS7) score is a well-validated metric of cardiovascular health shown to be associated with cognitive status in numerous cardiac cohorts. However, little is known regarding this relationship in older adults with atrial fibrillation (AF). We aim to characterize LS7 scores in this population and examine its relationship with cognitive status. Hypothesis: We hypothesize that LS7 score is associated with cognitive status in older adults with AF. Methods: The Systematic Assessment of Geriatric Elements in AF (SAGE-AF) study is a longitudinal cohort of patients over 65 years of age who are diagnosed with AF from Massachusetts and Georgia. The LS7 components are collected through self-reported data from the baseline visit as well as medical records. Cognitive status is operationalized using the Montreal Cognitive Assessment (MoCA). Descriptive statistics were calculated and univariate logistic regression using tertiles of LS7 as exposure was used to assess the relationship between LS7 score and cognitive status. Results: A total of 1241 participants were included in study sample. Average age of the population was 76, 49% were female, and most of the sample were White (89%). Mean LS7 score was 7.92 (SD 2.05), and the tertile thresholds were 0-6, 7-9, and 10-14 (n = 302, 671, 268). Those in the lowest and middle tertiles of LS7 score were more likely than those in the highest to be cognitively impaired (lowest - OR 1.86, 95% CI 1.33 - 2.61; middle - OR 1.52, 95% CI 1.14 - 2.03) Conclusions: Most older adults with AF had LS7 scores of between 7-9 out of 14, and those with more favorable cardiovascular health were less likely to be cognitively impaired.

Abstract 92: Stroke Survivors Experience Greater Decline in Life’s Simple 7 Score for Cardiovascular Health Over 10-Year Follow-Up

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Chelsea Liu ◽  
David L Roth ◽  
Orla C Sheehan ◽  
Marcela D Blinka ◽  
Rebecca Gottesman
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Racial Differences ◽  
Cardiovascular Health ◽  
Lifestyle Modification ◽  
Cognitive Status ◽  
Stroke Survivors ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Introduction: Life’s Simple 7 (LS7) is a measure of cardiovascular health based on seven domains of smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. Due to secondary prevention efforts, stroke survivors may experience improvements in LS7 scores over time compared to those who did not experience a stroke. Methods: We included participants over 45 years of age enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who had LS7 data at baseline and 10-year follow-up and did not report a history of stroke at baseline (N=7568). Of these, 361 had an adjudicated ischemic stroke between the LS7 assessments. Scores on each domain of LS7 range from 1-3 for a maximum total score of 21, where a higher score represents better cardiovascular health. A general linear model was used to test the association of having an ischemic stroke on the change in LS7 score. Covariates included the LS7 score at baseline, age, race, gender, cognitive status, and education. Results: Findings indicated that those who were younger, African American, and had lower levels of education, experienced significant decline in LS7 scores from baseline to follow-up (Table 1). Those who had a stroke also experienced, on average, 0.25 points more decline in total LS7 scores than those who did not have a stroke (p=0.048). Conclusions: Stroke survivors did not experience improvements in cardiovascular health due to secondary prevention after an ischemic stroke. On the contrary, they experienced significantly greater decline, indicating the need for greater efforts in lifestyle modification and secondary prevention after a stroke.

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.

scholarly journals Characteristics Associated With Facebook Use and Interest in Digital Disease Support Among Older Adults With Atrial Fibrillation: Cross-Sectional Analysis of Baseline Data From the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) Cohort

JMIR Cardio ◽  
10.2196/15320 ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. e15320 ◽  
Author(s):  
Molly E Waring ◽  
Mellanie T Hills ◽  
Darleen M Lessard ◽  
Jane S Saczynski ◽  
Brooke A Libby ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Health Care ◽  
Technology Use ◽  
Health Care Team ◽  
Online Health Information ◽  
Online Support ◽  
Systematic Assessment ◽  
Trade School ◽  
Facebook Use

Background Online support groups for atrial fibrillation (AF) and apps to detect and manage AF exist, but the scientific literature does not describe which patients are interested in digital disease support. Objective The objective of this study was to describe characteristics associated with Facebook use and interest in digital disease support among older patients with AF who used the internet. Methods We used baseline data from the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF), a prospective cohort of older adults (≥65 years) with AF at high stroke risk. Participants self-reported demographics, clinical characteristics, and Facebook and technology use. Online patients (internet use in the past 4 weeks) were asked whether they would be interested in participating in an online support AF community. Mobile users (owns smartphone and/or tablet) were asked about interest in communicating with their health care team about their AF-related health using a secure app. Logistic regression models identified crude and multivariable predictors of Facebook use and interest in digital disease support. Results Online patients (N=816) were aged 74.2 (SD 6.6) years, 47.8% (390/816) were female, and 91.1% (743/816) were non-Hispanic white. Roughly half (52.5%; 428/816) used Facebook. Facebook use was more common among women (adjusted odds ratio [aOR] 2.21, 95% CI 1.66-2.95) and patients with mild to severe depressive symptoms (aOR 1.50, 95% CI 1.08-2.10) and less common among patients aged ≥85 years (aOR 0.27, 95% CI 0.15-0.48). Forty percent (40.4%; 330/816) reported interest in an online AF patient community. Interest in an online AF patient community was more common among online patients with some college/trade school or Bachelors/graduate school (aOR 1.70, 95% CI 1.10-2.61 and aOR 1.82, 95% CI 1.13-2.92, respectively), obesity (aOR 1.65, 95% CI 1.08-2.52), online health information seeking at most weekly or multiple times per week (aOR 1.84, 95% CI 1.32-2.56 and aOR 2.78, 95% CI 1.86-4.16, respectively), and daily Facebook use (aOR 1.76, 95% CI 1.26-2.46). Among mobile users, 51.8% (324/626) reported interest in communicating with their health care team via a mobile app. Interest in app-mediated communication was less likely among women (aOR 0.48, 95% CI 0.34-0.68) and more common among online patients who had completed trade school/some college versus high school/General Educational Development (aOR 1.95, 95% CI 1.17-3.22), sought online health information at most weekly or multiple times per week (aOR 1.86, 95% CI 1.27-2.74 and aOR 2.24, 95% CI 1.39-3.62, respectively), and had health-related apps (aOR 3.92, 95% CI 2.62-5.86). Conclusions Among older adults with AF who use the internet, technology use and demographics are associated with interest in digital disease support. Clinics and health care providers may wish to encourage patients to join an existing online support community for AF and explore opportunities for app-mediated patient-provider communication.

Abstract P119: Assessment of Cardiovascular Health among Older Women in Primary Care

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Randi E Foraker ◽  
Abigail B Shoben ◽  
Marcelo A Lopetegui ◽  
Albert M Lai ◽  
Philip R Payne ◽  
...  
Keyword(s):  
Primary Care ◽  
Cardiovascular Health ◽  
Primary Care Clinic ◽  
Primary Care Providers ◽  
Continuous Variables ◽  
Care Providers ◽  
Care Clinic ◽  
Female Patients ◽  
Life’S Simple 7 ◽  
Life's Simple 7

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.

Abstract 381: Life’s Simple 7 Cardiovascular Health Metrics versus Fuster-BEWAT Score to Predict the New 4-tiered Left Ventricular Hypertrophy Classification: Insight From a Large Asian-population

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Haoyu Wang ◽  
Yingxian Sun ◽  
Zugui Zhang ◽  
Kefei Dou ◽  
Jiang He
Keyword(s):  
Cardiovascular Health ◽  
Low Cost ◽  
Asian Population ◽  
Left Ventricular ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
End Diastolic Volume ◽  
C Statistic ◽  
Life’S Simple 7 ◽  
Life's Simple 7

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.

scholarly journals Life’s Simple 7 and Incident Hypertension: The REGARDS Study

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Timothy B. Plante ◽  
Insu Koh ◽  
Suzanne E. Judd ◽  
George Howard ◽  
Virginia J. Howard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Incident Hypertension ◽  
Black And White ◽  
Stroke Study ◽  
Life’S Simple 7 ◽  
Life's Simple 7 ◽  
Regards Study ◽  
White Adults

Background The Life’s Simple 7 (LS7) metric incorporates health behaviors (body mass index, diet, smoking, physical activity) and health factors (blood pressure, cholesterol, glucose) to estimate an individual’s level of cardiovascular health. The association between cardiovascular health and incident hypertension is unresolved. Hypertension’s threshold was recently lowered and it is unclear if better cardiovascular health is associated with lower risk of incident hypertension with the updated threshold or in a multirace cohort. We sought to assess the association between better LS7 score and risk of incident hypertension among Black and White adults using a 130/80 mm Hg hypertension threshold. Methods and Results We determined the association between LS7 metric and incident hypertension in the REGARDS (Reasons for Geographic and Racial Disparities in Stroke) study, including participants free of baseline hypertension (2003–2007) who completed a second visit between 2013 and 2016. Hypertension was defined as systolic/diastolic blood pressure ≥130/80 mm Hg or antihypertensive medication use. Each LS7 component was assigned 0 (poor), 1 (intermediate), or 2 (ideal) points. We generated a 14‐point score by summing points. Among 2930 normotensive participants (20% Black, 80% White), the median (25th–75th percentiles) LS7 total score was 9 (8–10) points. Over a median follow‐up of 9 years, 42% developed hypertension. In the fully adjusted model, each 1‐point higher LS7 score had a 6% lower risk of incident hypertension (risk ratio, 0.94 per 1 point; 95% CI, 0.92–0.96). Conclusions Better cardiovascular health was associated with lower risk of incident hypertension using a 130/80 mm Hg hypertension threshold among Black and White adults.

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.

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