Jonathan T Unkart1, Matthew A Allison2, Michael H Criqui2, Mary M McDermott3, Alexis C Wood4, Aaron R Folsom5, Donald Lloyd-Jones3, Laura J Rasmussen-Torvik6, Norrina Allen6, Gregory Burke7, Moyses Szklo8, Mary Cushman9, Robyn L McClelland10, Christina L Wassel11. 1. Division of Preventive Medicine, Department of Medicine and Public Health, University of California San Diego, La Jolla, California. Electronic address: junkart@ucsd.edu. 2. Division of Preventive Medicine, Department of Medicine and Public Health, University of California San Diego, La Jolla, California. 3. Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 4. USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas. 5. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota. 6. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 7. Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina. 8. Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland. 9. Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont. 10. Department of Biostatistics, University of Washington, Seattle, Washington. 11. Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont.
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.
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.
Authors: Margaret Kennedy; Cam Solomon; Teri A Manolio; Michael H Criqui; Anne B Newman; Joseph F Polak; Gregory L Burke; Paul Enright; Mary Cushman Journal: Arch Intern Med Date: 2005-09-12
Authors: Aaron R Folsom; Amil M Shah; Pamela L Lutsey; Nicholas S Roetker; Alvaro Alonso; Christy L Avery; Michael D Miedema; Suma Konety; Patricia P Chang; Scott D Solomon Journal: Am J Med Date: 2015-04-20 Impact factor: 4.965
Authors: Donald M Lloyd-Jones; Yuling Hong; Darwin Labarthe; Dariush Mozaffarian; Lawrence J Appel; Linda Van Horn; Kurt Greenlund; Stephen Daniels; Graham Nichol; Gordon F Tomaselli; Donna K Arnett; Gregg C Fonarow; P Michael Ho; Michael S Lauer; Frederick A Masoudi; Rose Marie Robertson; Véronique Roger; Lee H Schwamm; Paul Sorlie; Clyde W Yancy; Wayne D Rosamond Journal: Circulation Date: 2010-01-20 Impact factor: 29.690
Authors: David C Goff; Donald M Lloyd-Jones; Glen Bennett; Sean Coady; Ralph B D'Agostino; Raymond Gibbons; Philip Greenland; Daniel T Lackland; Daniel Levy; Christopher J O'Donnell; Jennifer G Robinson; J Sanford Schwartz; Susan T Shero; Sidney C Smith; Paul Sorlie; Neil J Stone; Peter W F Wilson Journal: J Am Coll Cardiol Date: 2013-11-12 Impact factor: 24.094
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: Nels C Olson; Mary Cushman; Suzanne E Judd; Leslie A McClure; Susan G Lakoski; Aaron R Folsom; Monika M Safford; Neil A Zakai Journal: J Am Heart Assoc Date: 2015-02-27 Impact factor: 5.501
Authors: Oluseye Ogunmoroti; Norrina B Allen; Mary Cushman; Erin D Michos; Tatjana Rundek; Jamal S Rana; Ron Blankstein; Roger S Blumenthal; Michael J Blaha; Emir Veledar; Khurram Nasir Journal: J Am Heart Assoc Date: 2016-10-20 Impact factor: 5.501
Authors: Tracie C Collins; David P Slovut; Robert Newton; William D Johnson; Sandra Larrivee; Jeremy Patterson; Judy A Johnston; Adolfo Correa Journal: Prev Med Rep Date: 2017-05-18
Authors: LaPrincess C Brewer; Janice Bowie; Joshua P Slusser; Christopher G Scott; Lisa A Cooper; Sharonne N Hayes; Christi A Patten; Mario Sims Journal: J Am Heart Assoc Date: 2022-08-24 Impact factor: 6.106