Association of Life’s Simple 7 with reduced clinically manifest abdominal aortic aneurysm: The ARIC study

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Abstract

To optimize cardiovascular health, the American Heart Association (AHA) has recommended ‘Life’s Simple 7 (LS7)’. We tested the hypothesis that greater adherence to the LS7 cardiovascular risk metric is associated with reduced risk of developing abdominal aortic aneurysm (AAA). A total of 14,375 black and white participants aged 45–64 years at the baseline visit of the Atherosclerosis Risk in Communities (ARIC) study cohort were included in this analysis. A 14-point summary score for LS7 was calculated, and participants were classified as having poor (0–4), average (5–9), or ideal (10–14) cardiovascular health. We also counted the number of ideal components. Poisson regression was used to calculate incidence rates for AAA, and Cox regression to calculate hazard ratios adjusted for age, race, sex, and socioeconomic status. Over 25 years of follow-up, we identified 545 clinically manifest AAA events. Incident rates per 1000 person-years declined markedly across LS7 categories: 3.4 for the ‘poor’ category, 2.2 for ‘average’, and 0.9 for ‘ideal’. Compared to individuals in the ‘poor’ LS7 category, individuals in the ‘average’ category had a 52% lower AAA risk (95% CI: 37% to 63%) and those in the ‘ideal’ category had an 80% lower risk (95% CI: 72% to 86%). For every additional ideal component, there was a 28% lower risk of AAA (95% CI: 23% to 33%). Greater adherence to the AHA’s LS7 cardiovascular risk metric is associated with a reduced risk of clinically manifest AAA. These findings support the recommendation to follow LS7 for primary prevention of AAA.

Original languageEnglish (US)
Pages (from-to)224-229
Number of pages6
JournalVascular Medicine (United Kingdom)
Volume24
Issue number3
DOIs
StatePublished - Jun 1 2019

Bibliographical note

Funding Information:
The authors thank the staff and participants of the ARIC study for their important contributions. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: the National Heart, Lung, and Blood Institute (NHLBI) supported this research through R01HL103695 and ARIC contracts HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I.

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: the National Heart, Lung, and Blood Institute (NHLBI) supported this research through R01HL103695 and ARIC contracts HHSN268201700001I, HHSN268201700002I, HHSN268201 700003I, HHSN268201700004I, and HHSN268201700005I.

Publisher Copyright:
© The Author(s) 2019.

Keywords

  • Atherosclerosis Risk in Communities (ARIC) study
  • Life’s Simple 7 (LS7)
  • abdominal aortic aneurysm (AAA)
  • epidemiology
  • primary prevention

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