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Association Between Temporal Changes in Life's Simple 7 Cardiovascular Health Metrics and Recurrent Coronary Heart
Yihong Ding1, Hui Chen2, Qingyong Zeng1
1Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (Y.D., Q.Z., D.H.).
Insights
Improving cardiovascular health using Life's Simple 7 (LS7) significantly reduces the risk of recurrent coronary heart disease (CHD). Maintaining or enhancing LS7 scores is crucial for managing patients with CHD and preventing future cardiac events.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Coronary heart disease (CHD) recurrence poses a significant health risk.
- Life's Simple 7 (LS7) is a measure of cardiovascular health, but its prognostic role in patients with existing CHD is not well-established.
Purpose of the Study:
- To investigate the association between changes in Life's Simple 7 (LS7) scores and the risk of recurrent coronary heart disease (CHD).
Main Methods:
- Utilized data from the US ARIC study, assessing LS7 scores at two time points (Visit 1 and Visit 3).
- Analyzed changes in LS7 categories, cumulative scores, and score changes (Δscore) in relation to recurrent CHD events.
- Employed Cox proportional hazards models to evaluate the associations.
Main Results:
- An improvement in LS7 score from poor/fair to moderate/ideal was linked to a 46% reduced risk of recurrent CHD (HR, 0.54).
- A decline in LS7 score from moderate/ideal to poor/fair increased the risk of recurrent CHD (HR, 1.82).
- Higher cumulative LS7 scores and greater increases in LS7 scores were associated with significantly lower risks of recurrent CHD.
Conclusions:
- Deterioration of cardiovascular health, as indicated by LS7 scores, is associated with increased recurrent CHD risk.
- Improvements in LS7 scores correlate with a reduced risk of recurrent CHD events.
- Longitudinal assessment and improvement of cardiovascular health are vital for managing patients with CHD.
Background:
The risk of recurrence remains high among patients with coronary heart disease (CHD). Life's Simple 7 (LS7), a composite indicator of cardiovascular health, has been associated with a lower risk of incident CHD, but its prognostic value among patients with CHD remains unclear. We aimed to examine the association between temporal changes in LS7 and recurrent CHD.
Methods:
Data were from the US ARIC study (Atherosclerosis Risk in Communities). LS7 scores were assessed at Visit 1 (1987-1989) and Visit 3 (1993-1995). LS7 changes were evaluated by change in LS7 category (from poor/fair [0-6] to moderate/ideal [7-14] or from moderate/ideal to poor/fair), cumulative LS7 score (as quartiles), and change in LS7 score (as quartiles). Recurrent CHD was identified through December 31, 2018. Cox models assessed the association between changes in LS7 and recurrent CHD risk.
Results:
Among 1330 participants (mean [SD] age, 55.2 [5.6] years, 50.2% female) included in transition analyses, 561 (42.2%) experienced recurrent events during 21 359.2 person-years of follow-up. Participants whose LS7 score improved from poor/fair to moderate/ideal showed a reduced risk of recurrent CHD (hazard ratio, 0.54 [95% CI, 0.40-0.74]), whereas those whose score declined from moderate/ideal to poor/fair exhibited an increased risk (hazard ratio, 1.82 [95% CI, 1.44-2.30]). Both a higher cumulative LS7 score and a greater increase in LS7 score were associated with a lower risk of recurrent CHD (hazard ratio, 0.38 [95% CI, 0.30-0.49] for Q4 versus Q1 of cumulative score and hazard ratio, 0.51 [95% CI, 0.38-0.68] for Q4 versus Q1 of Δscore).
Conclusions:
Deterioration in LS7 during follow-up was associated with an increased risk of recurrent CHD, whereas improvement in LS7 was associated with a reduced risk. These findings underscore the importance of preserving and improving cardiovascular health and support the potential value of longitudinal cardiovascular health assessment in the ongoing management of patients with CHD.
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