Life's Simple 7 and Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis

Jonathan T. Unkart*, Matthew A. Allison, Michael H. Criqui, Mary M. McDermott, Alexis C. Wood, Aaron R. Folsom, Donald Lloyd-Jones, Laura J. Rasmussen-Torvik, Norrina Allen, Gregory Burke, Moyses Szklo, Mary Cushman, Robyn L. McClelland, Christina L. Wassel

*Corresponding author for this work

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)262-270
Number of pages9
JournalAmerican Journal of Preventive Medicine
Volume56
Issue number2
DOIs
StatePublished - Feb 2019

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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    Unkart, J. T., Allison, M. A., Criqui, M. H., McDermott, M. M., Wood, A. C., Folsom, A. R., Lloyd-Jones, D., Rasmussen-Torvik, L. J., Allen, N., Burke, G., Szklo, M., Cushman, M., McClelland, R. L., & Wassel, C. L. (2019). Life's Simple 7 and Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis. American Journal of Preventive Medicine, 56(2), 262-270. https://doi.org/10.1016/j.amepre.2018.09.021