American Heart Association's Life's Simple 7 and risk of venous thromboembolism: the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.
BACKGROUND
The American Heart Association's Life's Simple 7 metric is being used to track the population's cardiovascular health (CVH) toward a 2020 goal for improvement. The metric includes body mass index (BMI), blood pressure, cholesterol, glucose, physical activity (PA), cigarette smoking, and diet. We hypothesized a lower risk of venous thromboembolism (VTE) with favorable Life's Simple 7 scores.


RESULTS
REGARDS recruited 30,239 black and white participants ≥45 years of age across the United States in 2003-2007. A 14-point summary score for Life's Simple 7 classified participants into inadequate (0 to 4 points), average (5 to 9 points), and optimal (10 to 14 points) categories. Hazard ratios (HRs) of incident VTE were calculated for these categories, adjusting for age, sex, race, income, education, and region of residence. For comparison, HRs of VTE were calculated using the Framingham 10-year coronary risk score. There were 263 incident VTE cases over 5.0 years of follow-up; incidence rates per 1000 person-years declined from 2.9 (95% confidence interval [CI], 2.3 to 3.7) among those in the inadequate category to 1.8 (95% CI, 1.4 to 2.4) in the optimal category. Compared to the inadequate category, participants in the average category had a 38% lower VTE risk (95% CI, 11 to 57) and participants in the optimal category had a 44% lower risk (95% CI, 18 to 62). The individual score components related to lower VTE risk were ideal PA and BMI. There was no association of Framingham Score with VTE.


CONCLUSIONS
Life's Simple 7, a CVH metric, was associated with reduced VTE risk. Findings suggest that efforts to improve the population's CVH may reduce VTE incidence.
Department of Pathology, University of Vermont College of Medicine, Burlington, VT (N.C.O., M.C., N.A.Z.).
Nels C
NC
Olson
Department of Pathology, University of Vermont College of Medicine, Burlington, VT (N.C.O., M.C., N.A.Z.) Department of Medicine, University of Vermont College of Medicine, Burlington, VT (M.C., S.G.L., N.A.Z.).
Mary
M
Cushman
Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (S.E.J., L.A.M.C.).
Suzanne E
SE
Judd
Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (S.E.J., L.A.M.C.).
Leslie A
LA
McClure
Department of Medicine, University of Vermont College of Medicine, Burlington, VT (M.C., S.G.L., N.A.Z.).
Susan G
SG
Lakoski
Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN (A.R.F.).
Aaron R
AR
Folsom
Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL (M.M.S.).
Monika M
MM
Safford
Department of Pathology, University of Vermont College of Medicine, Burlington, VT (N.C.O., M.C., N.A.Z.) Department of Medicine, University of Vermont College of Medicine, Burlington, VT (M.C., S.G.L., N.A.Z.).
Neil A
NA
Zakai
D000368:Aged; D000572:American Heart Association; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008019:Life Style / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control
epidemiology; risk; thrombosis