Association of Prevalent Stroke with Life's Simple Seven Score: Reasons for Geographic and Racial Differences Open Access

Cheng, Zhi (2012)

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Context: The American Heart Association's (AHA) Life's Simple 7 (LSS) metric includes
biological (body mass index, blood pressure, cholesterol, and glucose) and behavioral (cigarette
smoking, physical activity, diet, and body mass index) risk factors for cardiovascular disease.
Objective: Determine whether LSS scores differ among those with and without self-reported
prevalent stroke among REGARDS participants and if the association between self-reported
stroke and LSS score varies by race among REGARDS participants.
Design, Setting, and Participants: We included 24,795 participants without history of
cardiovascular disease from the population-based REasons for Geographic and Racial
Differences in Stroke (REGARDS) study (n=30,221). Data for LSS was collected by telephone,
mail questionnaires and an in-home exam. Each of LSS components was assessed at baseline and
categorized as being poor (0 point), intermediate (1 points) or ideal (2 points).An overall LSS
score was categorized as optimum (10-14), average (5-9) and inadequate (0-4) cardiovascular
health. Polytomous Logistic regression was to model LSS score categories with prevalence of
Results: There were 24,795 subjects with data on LSS and no past or prevalent history of CHD.
In the baseline, there was 1278 self-reported stroke. Cardiovascular health categories were
associated with prevalent stroke in a grade fashion. After controlling for age, race, sex, income,
region, and education, people without stroke was 3 times more likely to have optimum
Cardiovascular health (OR=3.21, 95%CI=2.46, 4.20) and 1.7 times likely to have average
Cardiovascular health compared to individuals with stroke. (OR=1.65, 95%CI= (1.42, 1.91))
Race did not has effect modification on the association was found. (P-value=0.20)
Conclusions: In both blacks and white, prevalent stroke is related to poorer cardiovascular health
based on LSS score and we need to improve it through a multiple intervention with health
behaviors and risk factors.

Table of Contents

Table of contents

Introduction 1
Methods 3
Results 7
Discussion 9
References 12
Appendix 16

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