Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

Rebholz, Casey M.; Anderson, Cheryl A.M.; Grams, Morgan E.; Bazzano, Lydia A.; Crews, Deidra C.; Chang, Alexander R.; Coresh, Josef; Appel, Lawrence J.

doi:10.1161/jaha.116.003192

Cited by 68 publications

(71 citation statements)

References 28 publications

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“…For dietary patterns in Life's Simple 7, some investigators raised a concern that adherence to the 5 AHA dietary recommendations is challenging 25. In fact, in our study as well as previous ones, the prevalence of ideal diet patterns is low (<1%–6%) 17, 18, 26, 27, 28. This might partially explain no significant association, even with incident MI, an analysis with much higher statistical power than the analysis after incident MI.…”

Section: Discussioncontrasting

confidence: 50%

“…25 In fact, in our study as well as previous ones, the prevalence of ideal diet patterns is low (<1%-6%). 17,18,[26][27][28] This might partially explain no significant association, even with incident MI, an analysis with much higher statistical power than the analysis after incident MI. Despite arguments for the so-called obesity paradox (ie, obesity increasing the risk of incident MI but decreasing the risk of adverse outcomes after MI), [29][30][31] ideal BMI at middle age was robustly associated with better prognosis after incident MI at later life in our study.…”

Section: Discussionmentioning

confidence: 97%

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American Heart Association's Life's Simple 7 at Middle Age and Prognosis After Myocardial Infarction in Later Life

Mok

Sang

Ballew

et al. 2018

JAHA

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BackgroundThe American Heart Association recommends focusing on 7 health factors (Life's Simple 7) for primordial prevention of cardiovascular health. However, whether greater adherence to Life's Simple 7 in midlife improves prognosis after myocardial infarction (MI) in later life is unknown.Methods and ResultsIn 1277 participants who developed MI during the ARIC (Atherosclerosis Risk in Communities) Study follow‐up, a 14‐point score of Life's Simple 7 was constructed according to the status (2 points for ideal, 1 point for intermediate, and 0 points for poor) of each of 7 factors (smoking, adiposity, physical activity, diet, total cholesterol, blood pressure, and fasting glucose) at baseline (1987–1989). Hazard ratios for composite and individual adverse outcomes of all‐cause mortality, cardiovascular mortality, recurrent MI, heart failure, and stroke were calculated according to Life's Simple 7 score. During a median follow‐up of 3.3 years, 918 participants (72%) had subsequent adverse outcomes after MI. Life's Simple 7 score at middle age was inversely associated with adverse outcomes after MI (adjusted hazard ratios of composite outcome, 0.57 [95% confidence interval, 0.39–0.84] if score is ≥10, 0.78 [95% confidence interval, 0.57–1.07] if score is 7–9, and 0.82 [95% confidence interval, 0.60–1.11] if score is 4–6 versus ≤3). The association was largely independent of access to care and MI severity. Individual factors related to better prognosis after MI were ideal nonsmoking, body mass index, blood pressure, and fasting glucose.ConclusionsOptimal Life's Simple 7 at middle age was associated with better prognosis after MI in later life. Our findings suggest a secondary prevention benefit of having better cardiovascular health status in midlife.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 97%

American Heart Association's Life's Simple 7 at Middle Age and Prognosis After Myocardial Infarction in Later Life

Mok

Sang

Ballew

et al. 2018

JAHA

Self Cite

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“…Fifteen studies (79,998 participants) reported incident CKD (22)(23)(24)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) across eight datasets (22,23,27,29,30,32,34,36). Four studies reported data from the Tehran Lipid and Glucose Study 2006Study -2008, one study reported three different analyses from the Tehran Lipid and Glucose Study 2009-2011 (27), four studies reported data from the Atherosclerosis Risk in Communities study (24,33,34,39), and two studies reported data from the Framingham Offspring Cohort (28,29). In a meta-analysis including eight studies from the eight eligible cohort datasets (31,410 participants; mean, 7.1 years follow-up), adherence to a healthy dietary pattern was associated with lower odds of incident CKD (OR, 0.70; 95% CI, 0.60 to 0.82; I 2 =51%) with moderate certainty of evidence (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

Healthy Dietary Patterns and Incidence of CKD

Bach

Kelly

Palmer

et al. 2019

CJASN

154

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Background and objectives Whether a healthy dietary pattern may prevent the incidence of developing CKD is unknown. This study evaluated the associations between dietary patterns and the incidence of CKD in adults and children. Design, setting, participants, & measurements This systematic review and meta-analysis identified potential studies through a systematic search of MEDLINE, Embase and references from eligible studies from database inception to February 2019. Eligible studies were prospective and retrospective cohort studies including adults and children without CKD, where the primary exposure was dietary patterns. To be eligible, studies had to report on the primary outcome, incidence of CKD (eGFR,60 ml/min per 1.73 m 2). Two authors independently extracted data, assessed risk of bias and evidence certainty using the Newcastle-Ottawa scale and GRADE. Results Eighteen prospective cohort studies involving 630,108 adults (no children) with a mean follow-up of 10.467.4 years were eligible for analysis. Included studies had an overall low risk of bias. The evidence certainty was moderate for CKD incidence and low for eGFR decline (percentage drop from baseline or reduced by at least 3 ml/min per 1.73 m 2 per year) and incident albuminuria. Healthy dietary patterns typically encouraged higher intakes of vegetables, fruit, legumes, nuts, whole grains, fish and low-fat dairy, and lower intakes of red and processed meats, sodium, and sugar-sweetened beverages. A healthy dietary pattern was associated with a lower incidence of CKD (odds ratio [OR] 0.70 (95% confidence interval [95% CI], 0.60 to 0.82); I 2 =51%; eight studies), and incidence of albuminuria (OR 0.77, [95% CI, 0.59 to 0.99]; I 2 =37%); four studies). There appeared to be no significant association between healthy dietary patterns and eGFR decline (OR 0.70 [95% CI, 0.49 to 1.01], I 2 =49%; four studies). Conclusions A healthy dietary pattern may prevent CKD and albuminuria.

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“…9, 11, 28–33 Among 3,107 African American participants of the ARIC study who were followed for a median 18.7 years, the age-sex adjusted CVD incidence rates per 1,000 person years (95% CI) for participants with 0, 1, 2, 3, 4 and ≥5 ideal Life’s Simple 7 components were 40.4 (32.0–51.5), 25.3 (22.4–28.6), 16.9 (15.0–19.1), 14.2 (12.2–16.5), 8.7 (6.6–11.5) and 3.3 (1.5–7.4), respectively. 29 Having more Life’s Simple 7 components in the ideal range has also been associated with a lower risk for incident cognitive impairment 34, 35 , venous thromboembolism 36 , vascular and non-vascular death, 28 end-stage renal disease 37 and CKD 38 in African Americans.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Health and Incident Hypertension in Blacks

et al. 2017

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Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trend<0.001). This association was present among participants with baseline systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg and, separately systolic blood pressure 120–139 or diastolic blood pressure 80–89 mmHg. African-Americans with better cardiovascular health have lower hypertension risk.

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Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

Cited by 68 publications

References 28 publications

American Heart Association's Life's Simple 7 at Middle Age and Prognosis After Myocardial Infarction in Later Life

American Heart Association's Life's Simple 7 at Middle Age and Prognosis After Myocardial Infarction in Later Life

Healthy Dietary Patterns and Incidence of CKD

Cardiovascular Health and Incident Hypertension in Blacks

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