Abstract 339: Association of the American Heart Association’s Life’s Simple 7 Metric for Cardiovascular Health with Risk of Venous Thrombosis: the Reasons for Geographic and Racial Differences in Stroke Cohort
Background The AHA released a metric, Life’s Simple 7 (LS7), in 2010 to track cardiovascular health. The AHA 2020 Goals include improving population levels of LS7 by 20%. LS7 classifies 7 health components into poor, intermediate or ideal levels. The 7 components are physical activity, diet, smoking, body-mass index, glucose, blood pressure and cholesterol. Associations of these individual components with risk of venous thrombosis (VT) vary in the literature, but we hypothesized a decreased risk of VT with favorable LS7 summary scores.
Methods We recruited 30,239 black and white participants age ≥45 across the US in 2003-7. With 4.6 years of follow up we validated 278 cases of first-time VT, including deep vein thrombosis and pulmonary embolus. We considered a 14 point summary score for LS7 and divided it into inadequate (0-4 points), average (5-9 points) and optimum (10-14) cardiovascular health. Cox proportional hazards models were used to relate baseline LS7 score to risk of subsequent VT, adjusting for age, sex, race, income, education and region of residence.
Results Cases of VT were older and more likely to be male than noncases. Across categories of optimum, average and inadequate baseline health based on the summary LS7 score, the incidence rates of VT were 1.8, 2.1 and 3.1 per 1000 person years, respectively. Compared to those with inadequate health, persons with average health had an adjusted HR of VT of 0.60 (95% CI 0.42-0.84) while those with optimum health had a HR 0.52 (95% CI 0.36-0.77). The HR for a 1 point improvement in overall score (analogous to improvement of one of the 7 factors from poor–>intermediate or intermediate–>ideal) was 0.87 (95% CI 0.81-0.94). The individual factors of LS7 most strongly related to VT risk were ideal physical activity level (HR 0.61, 95% CI 0.46-0.83) and ideal body-mass index (HR 0.42, 95% CI 0.30-0.60); these associations were independent of each other. All associations were similar in blacks and whites.
Conclusions A summary measure of cardiovascular health was strongly associated with reduced risk of VT in this US population sample. Results suggest that lifestyle interventions might be effective in reducing incidence of VT, and that achieving AHA’s 2020 Goals will also reduce VT incidence.
- © 2013 by American Heart Association, Inc.