Oluseye Ogunmoroti1, Erin D Michos2, Konstantinos N Aronis3, Joseph A Salami4, Ron Blankstein5, Salim S Virani6, Erica S Spatz7, Norrina B Allen8, Jamal S Rana9, Roger S Blumenthal2, Emir Veledar10, Moyses Szklo11, Michael J Blaha2, Khurram Nasir7. 1. Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA; Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA. Electronic address: seyeogunmoroti@gmail.com. 2. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA. 3. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA; Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA. 5. Brigham and Women's Hospital, Boston, MA, USA. 6. Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA. 7. Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA; Section of Cardiovascular Medicine, Yale University, New Haven, CT, USA. 8. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 9. Division of Cardiology and Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA. 10. Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA; Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA. 11. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
BACKGROUND AND AIMS: We examined the association between the American Heart Association's Life's Simple 7 (LS7) metrics and the risk of atrial fibrillation (AF) in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of adults free of cardiovascular disease (CVD) at baseline. METHODS: We analyzed data from 6506 participants. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each categorized into ideal (assigned 2 points), intermediate (1 point) or poor (0 points). Scores were summed for a maximum of 14. A score of 0-8 was considered inadequate; 9-10, average and 11-14, optimal for cardiovascular health. Atrial fibrillation was ascertained using ICD-9 codes from hospital discharge records and Medicare claims data. Cox proportional hazard ratios (HR) and incidence rates of AF per 1000 person-years were calculated. RESULTS: During a median follow-up of 11.2 years (interquartile range: 10.6-11.7 years), 709 (11%) participants were hospitalized with a first AF episode. In the overall cohort, optimal scores at baseline were associated with a 27% lower risk for AF compared with inadequate scores (0.73 [0.59-0.91]). A similar finding was observed when the results were stratified by race/ethnicity (White, Chinese American, African American and Hispanic), though many of the associations were not statistically significant. There was no interaction by race/ethnicity (p = 0.15). CONCLUSIONS: In the overall cohort, optimal LS7 status was associated with a lower risk of AF. These findings suggest that promoting ideal cardiovascular health may reduce the incidence and burden of AF.
BACKGROUND AND AIMS: We examined the association between the American Heart Association's Life's Simple 7 (LS7) metrics and the risk of atrial fibrillation (AF) in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of adults free of cardiovascular disease (CVD) at baseline. METHODS: We analyzed data from 6506 participants. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each categorized into ideal (assigned 2 points), intermediate (1 point) or poor (0 points). Scores were summed for a maximum of 14. A score of 0-8 was considered inadequate; 9-10, average and 11-14, optimal for cardiovascular health. Atrial fibrillation was ascertained using ICD-9 codes from hospital discharge records and Medicare claims data. Cox proportional hazard ratios (HR) and incidence rates of AF per 1000 person-years were calculated. RESULTS: During a median follow-up of 11.2 years (interquartile range: 10.6-11.7 years), 709 (11%) participants were hospitalized with a first AF episode. In the overall cohort, optimal scores at baseline were associated with a 27% lower risk for AF compared with inadequate scores (0.73 [0.59-0.91]). A similar finding was observed when the results were stratified by race/ethnicity (White, Chinese American, African American and Hispanic), though many of the associations were not statistically significant. There was no interaction by race/ethnicity (p = 0.15). CONCLUSIONS: In the overall cohort, optimal LS7 status was associated with a lower risk of AF. These findings suggest that promoting ideal cardiovascular health may reduce the incidence and burden of AF.
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