title: Life's Simple 7 and risk of incident stroke: the reasons for geographic and racial differences in stroke study.
abstract: OBJECTIVE
  The American Heart Association developed Life's Simple 7 (LS7) as a metric defining cardiovascular health. We investigated the association between LS7 and incident stroke in black and white Americans.
  
  
  METHODS
  The Reasons for Geographic And Racial Differences in Stroke (REGARDS) is a national population-based cohort of 30 239 blacks and whites, aged ≥45 years, sampled from the US population from 2003 to 2007. Data were collected by telephone, self-administered questionnaires, and an in-home examination. Incident strokes were identified through biannual participant contact followed by adjudication of medical records. Levels of the LS7 components (blood pressure, cholesterol, glucose, body mass index, smoking, physical activity, and diet) were each coded as poor (0 point), intermediate (1 point), or ideal (2 points) health. An overall LS7 score was categorized as inadequate (0-4), average (5-9), or optimum (10-14) cardiovascular health.
  
  
  RESULTS
  Among 22 914 subjects with LS7 data and no previous cardiovascular disease, there were 432 incident strokes over 4.9 years of follow-up. After adjusting for demographics, socioeconomic status, and region of residence, each better health category of the LS7 score was associated with a 25% lower risk of stroke (hazard ratios, 0.75; 95% confidence interval, 0.63-0.90). The association was similar for blacks and whites (interaction P value=0.55). A 1-point higher LS7 score was associated with an 8% lower risk of stroke (hazard ratios, 0.92; 95% confidence interval, 0.88-0.95).
  
  
  CONCLUSIONS
  In both blacks and whites, better cardiovascular health, on the basis of the LS7 score, is associated with lower risk of stroke, and a small difference in scores was an important stroke determinant.
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, GA, USA.
authors.forename: Ambar
authors.initials: A
authors.lastname: Kulshreshtha
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.forename: William M
authors.initials: WM
authors.lastname: McClellan
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Yuling
authors.initials: Y
authors.lastname: Hong
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.forename: Abhinav
authors.initials: A
authors.lastname: Goyal
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
mesh_terms: D000368:Aged; D044383:Black People / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012306:Risk; D020521:Stroke / Q000191:economics / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000208:ethnology
keywords: racial differences; risk factors; stroke