Life's simple 7 and incident heart failure: the multi-ethnic study of atherosclerosis

Background--the american heart association introduced the life's simple 7 (ls7) metrics to assess and promote cardiovascular health. we sought to examine the association between the ls7 metrics and incident heart failure (hf) in a multiethnic cohort. methods and results--we analyzed data from 6506 participants of the multi-ethnic study of atherosclerosis free of cardiovascular disease at baseline. the ls7 metrics (smoking,physical activity,body mass index,diet,blood pressure,total cholesterol,and blood glucose) were graded on a scale of 0 to 2,with 2 indicating ideal status,1 intermediate status,and 0 poor status. points were summed,thus the ls7 score ranged from 0 to 14. cox proportional hazard ratios and incidence rates of hf per 1000 person-years were calculated. during a median follow-up of 12.2 years,262 (4%) participants developed hf. incidence of hf decreased as the number of ideal ls7 metrics increased; 5.9 per 1000 person-years for participants with 0 to 1 ideal metrics and 0.6 per 1000 person-years for those with 6 to 7 ideal metrics. compared with inadequate scores (0-8 points),hazard ratios for hf were 0.57 (0.43-0.76) and 0.31 (0.19-0.49) for average (9-10 points) and optimal (11-14 points) scores,respectively. a similar pattern was observed when the results were stratified by 4 racial/ethnic groups: white,chinese american,black,and hispanic. conclusions--a lower risk of hf with more favorable ls7 status regardless of race/ethnicity suggests that efforts to achieve ideal cardiovascular health may reduce the burden of hf,a major source of morbidity and mortality. © 2017 the authors.