Clinical research studyAmerican Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function
Section snippets
Study Population
The ARIC Study9 enrolled 15,792 men and women ages 45 to 64 years in 1987-1989, in 4 US communities: Forsyth Co., NC, Jackson, MS (African Americans only), suburban Minneapolis, MN, and Washington Co., MD. The investigators followed the cohort for incident cardiovascular disease events and conducted 4 subsequent examinations, including an echocardiogram at Visit 5 in 2011-2013, approximately 25 years after baseline. The institutional review committees at each study center approved the methods,
Heart Failure Incidence in Relation to Life's Simple 7
Among 13,462 ARIC participants initially free of heart failure at ages 45-64 years, the mean (SD) age was 54.1 (5.8) years, 24.3% were African American, and 54.6% were women. We followed them for a median of 22.5 years and identified 2218 incident heart failure events. As shown in Table 1, participants having ≥ 4 ideal components of Life's Simple 7 in middle age had less than one-third the heart failure incidence rate of those with no ideal health components. Moreover, each of the 7 ideal
Discussion
In this prospective middle-aged cohort followed 25 years, 1 in 4 participants sustained a hospitalized or fatal heart failure event by age 85 years. However, those who in middle age met more of AHA Life's Simple 7 metrics, had substantially lower lifetime risk of heart failure—approximately 30% of the lifetime risk for those with our “optimal” Life's Simple 7 score and 55% of the lifetime risk for an “average” score, compared with an “inadequate” score. Furthermore, among those who had not yet
Conclusion
Greater achievement of AHA's Life's Simple 7 in middle age is associated with a lower lifetime occurrence of heart failure and with greater preservation of cardiac structure and function in late life. Because ARIC is not a clinical trial, we cannot prove cause and effect, but all of the Life's Simple 7 risk factors and health behaviors are believed to be causative, and clinical trial evidence supports the value of reducing most of them. To lessen the public health burden of heart failure,7
Acknowledgment
The authors thank the staff and participants of the ARIC Study for their important contributions.
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Cited by (0)
Funding:National Heart, Lung, and Blood Institute (NHLBI) Atherosclerosis Risk in Communities (ARIC) contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C, and grant K08HL116792 (AMS).
Conflict of Interest: None.
Authorship: All authors had access to the data and participated in creating this manuscript.