Life's Simple 7 and Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis

Jonathan T. Unkart, Matthew A. Allison, Michael H. Criqui, Mary M. McDermott, Alexis C. Wood, Aaron R. Folsom, Donald Lloyd-Jones, Laura J. Rasmussen-Torvik, Norrina Allen, Gregory Burke, Moyses Szklo, Mary Cushman, Robyn L. McClelland, Christina L. Wassel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction: In 2010, the American Heart Association initiated Life's Simple 7 with the goal of significantly improving cardiovascular health by the year 2020. The association of Life's Simple 7 with risk of peripheral artery disease has not been thoroughly explored. Methods: Racially diverse individuals from the Multi-Ethnic Study of Atherosclerosis (2000–2012) were followed for incident peripheral artery disease (ankle brachial index ≤0.90) and decline in ankle brachial index (≥0.15) over approximately 10 years of follow-up. Cox and logistic regression were used to assess associations of individual Life's Simple 7 components (score 0–2) and overall Life's Simple 7 score (score 0–14) with incident peripheral artery disease and ankle brachial index decline, respectively, adjusted for age, sex, race/ethnicity, education, and income. Analyses were performed in 2016–2018. Results: Of 5,529 participants, 251 (4.5%) developed incident peripheral artery disease; 419 (9.8%) of 4,267 participants experienced a decline in ankle brachial index. Each point higher for the overall Life's Simple 7 score was associated with a 17% lower rate of incident peripheral artery disease (hazard ratio=0.83, 95% CI=0.78, 0.88, p<0.001). Additionally, each point higher in overall Life's Simple 7 was associated with a 0.94-fold lower odds of decline in ankle brachial index (OR=0.94, 95% CI=0.87, 0.97, p=0.003). Four components (smoking, physical activity, glucose, and blood pressure) were associated with incident peripheral artery disease and two (smoking and glucose) with decline in ankle brachial index. Conclusions: Better cardiovascular health as measured by Life's Simple 7 is associated with lower incidence of peripheral artery disease and less decline in ankle brachial index. Use of the Life's Simple 7 to target modifiable health behaviors may aid in decreasing the population burden of peripheral artery disease–related morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)262-270
Number of pages9
JournalAmerican journal of preventive medicine
Volume56
Issue number2
DOIs
StatePublished - Feb 2019

Bibliographical note

Funding Information:
The authors thank the other investigators, the staff, and the participants of the Multi-Ethnic Study of Atherosclerosis (MESA) study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at www.mesa-nhlbi.org. This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) at NIH via MESA contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169, and R01 HL098077 to SJB, and by grants UL1-TR-000040 and UL1-RR-025005 from National Center for Research Resources. Additionally, we like to thank NHLBI for University of California, San Diego, training grant support (2T32HL079891). No financial disclosures were reported by the authors of this paper.

Funding Information:
This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) at NIH via MESA contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169, and R01 HL098077 to SJB, and by grants UL1-TR-000040 and UL1-RR-025005 from National Center for Research Resources. Additionally, we like to thank NHLBI for University of California, San Diego, training grant support (2T32HL079891).

Fingerprint Dive into the research topics of 'Life's Simple 7 and Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis'. Together they form a unique fingerprint.

Cite this