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

14 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

Publisher Copyright:
© 2018 Elsevier Ltd

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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