AHA's "Life's Simple 7" Reduces Heart Failure Risk

July 25, 2019

Study: "Ideal" adherence to healhty habits (eg, weight control, no smoking, average A1c) may reduce risk of heart failure by >50% vs "inadequate" adherence.

The incidence of congestive heart failure (HF) was reduced by 47% in a group of individuals adhering to a combination of healthy lifestyle practices; among individuals who adhered to an “ideal” combination of those practices, HF was reduced by 55%. Ina recent study that analyzed the impact of the American Heart Association’s (AHA) Life’s Simple 7 (LS7) healthy behaviors on HF risk reduction, the behaviors most associated with protection from HF were glucose control, maintaining BMI within normal range, non-smoking status, and blood pressure control. Reductions were relative to that seen in participants with baseline “inadequate adherence.”

The results were published in the July issue of the Journal of the American College of Cardiologists.

The remaining risk-reduction measures that make up the AHA LS7 are adequate physical activity, balanced nutritional/caloric intake, and lipids within normal range.

The 37,803 study participants were from the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort (mean age 49.4 ± 11.9 years, 74.7% women). Each participant was assigned a LS7 score ranging from 0 to 14 that was calculated by assigning 0, 1, or 2 points for smoking, physical activity, body mass index (BMI), diet, blood pressure, total cholesterol, and blood glucose. The majority earned an inadequate score, approximately one-third had an intermediate score, and less than one-quarter earned an ideal score:

  • Ideal   11-14 pts             23.2%

  • Intermediate  9-10 pts   35.3%

  • Inadequate  0-8 points   41.5%

During follow-up of a median of 15.2 years, HF was experienced by 690 participants (1.8%). In Cox proportional hazards models, ideal and intermediate LS7 scores were associated with reduced risk for HF compared with the inadequate category (hazard ratios: 0.45 [95% confidence interval (CI): 0.34 to 0.60] and 0.53 [95% CI: 0.44 to 0.64], respectively).

The authors conclude, "Preventive strategies that target combinations of specific LS7 components could have a significant impact on decreasing incident HF in the population at large."

Heart failure affects nearly 5 million Americans; HF is responsible for 11 million physician office visits each year, and for more hospitalizations than all forms of cancer combined. Sudden death is common in patients with CHF and occurs 6 to 9 times more frequently than among the general population.

In a commentary on the study written for the online news site Practice Update, Paul Thompson, MD, recalls hearing a story about physicians treating injured patients who had fallen from the top of a cliff. A bystander who asks why they don’t just build a fence around the cliff’s perimeter to prevent the accidents, is told there’s no money for that – it’s all being spent here, at the bottom.

Dr Thompson’s story hints at the “simple” in Life’s Simple 7, ie, many of our most burdensome health problems could be prevented through simple lifestyle modifications; it also speaks directly to the extraordinary annual US expenditures on chronic health conditions, ie, here, the bottom of our cliff.