Ideal cardiovascular health and cardiovascular-related events: a systematic review and meta-analysis

Abstract

Abstract Aims The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple’s 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs). Methods and results EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias. Data were analysed with a random-effects meta-analysis. This meta-analysis included 59 studies (1 881 382 participants). Participants with ideal CVH had a considerably lower risk of a variety of CVDs and CMDs as compared with those with poor CVH, varying from 40% lower risk for atrial fibrillation (AF) {hazard ratio [HR] = 0.60 [95% confidence interval (CI) 0.44–0.83]} to 82% lower risk for myocardial infarction [HR = 0.18 (95% CI 0.12–0.28)]. Intermediate CVH was associated with 27–57% lower risk in CVDs and CMDs compared with poor CVH, with the highest hazard for AF [HR = 0.73 (95% CI 0.59–0.91)] and the lowest hazard for peripheral arterial disease [HR = 0.43 (95% CI 0.30–0.60)]. Conclusion Ideal and moderate CVH were associated with a lower incidence of CVDs and CMDs than poor CVH. Life Simple’s 7 holds significant potential for promoting overall CVH and thereby contributing to the prevention of CVDs. Lay summary Healthy lifestyle is very important to prevent cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs), such as diabetes and kidney diseases. Therefore, in 2010, the American Heart Association introduced Life’s Simple 7 (LS7), a scoring system using seven lifestyle factors to measure cardiovascular health in populations, and these factors are diet, physical activity, smoking, blood pressure, blood lipids, blood sugar, and weight. In this review, we investigated the relationship between LS7 score and CVDs or CMDs. Key findings