American Heart Association's Life's Simple 7 and Risk of Venous Thromboembolism: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Mar 1, 2015Journal of the American Heart Association

Heart health factors and risk of blood clots in veins: results from a study on racial and regional stroke differences

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Abstract

Participants with optimal Life's Simple 7 scores had a 44% lower risk of venous thromboembolism compared to those with inadequate scores.

A total of 30,239 participants aged 45 and older were recruited for this study.
263 cases of venous thromboembolism were documented over a 5-year follow-up period.
VTE incidence rates per 1000 person-years decreased from 2.9 in the inadequate category to 1.8 in the optimal category.
Participants in the average Life's Simple 7 category had a 38% lower risk of VTE compared to the inadequate category.
The components of Life's Simple 7 most strongly associated with lower VTE risk were ideal physical activity and body mass index.
No association was found between the Framingham Score and VTE risk.

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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.

METHODS AND 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.

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American Heart Association's Life's Simple 7 and Risk of Venous Thromboembolism: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

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