Abstract
Introduction: Atrial fibrillation (AF) causes substantial morbidity and mortality. The Life’s Simple 7 (LS7) metrics serve as a marker of “ideal cardiovascular health” and provide a framework for decreasing the overall burden of cardiovascular diseases. We examined the association between the LS7 metrics and incident AF in MESA, a multicenter prospective cohort study. Methods: The study population comprised 6,814 men and women, free of established cardiovascular disease at baseline. “Ideal cardiovascular health” was measured from the components of the LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose). The metrics were categorized into: ideal (assigned 2 points); intermediate (1 point) and poor (0 point). Scores for each participant, were summed for a maximum score of 14. A score of 0-8 was inadequate; 9-10, average and 11-14, optimal. Cox proportional hazard ratios and incidence rates per 1000 person years were calculated from ICD-9 diagnosis of AF. Hazard ratios were adjusted for age, sex, education, income and health insurance. Results: After excluding participants with incomplete data, the final study population was 6,506 (53% women, mean age 62 ±10 years). During a median follow-up of 11.2 years, 355 participants (5.5%) developed AF. Overall, optimal and average scores were associated with a lower hazard for AF compared with inadequate scores [0.59 (0.43-0.81) and 0.92 (0.76-1.13) respectively]. A similar trend was mostly observed when the results were stratified by race/ethnicity (Table). Conclusion: Favorable LS7 status is associated with a lower risk of AF across all race/ethnic groups. These findings suggest that promoting ideal cardiovascular health may reduce the incidence of AF including its complications and healthcare expenditure.