Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Abstract

Background The American Heart Association introduced the Life's Simple 7 ( LS 7) metrics to assess and promote cardiovascular health. We sought to examine the association between the LS 7 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 LS 7 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 LS 7 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 LS 7 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 LS 7 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.