#VisualAbstract: Life’s Simple 7 and Incident Hypertension: The REGARDS Study

1. A 6% risk reduction for developing hypertension was associated with a 1-point improvement in Life’s Simple 7 score, a metric for cardiovascular health.

Evidence Rating Level: 2 (Good)

Hypertension is a condition that affects roughly half of the adult US population, and is a known risk factor for cardiovascular disease (CVD), stroke, and numerous other health concerns. Although behaviours that are associated with better cardiovascular health (CVH) appear to lower blood pressure, such as exercise and weight loss, the relationship between CVH and hypertension risk is not well-researched. For instance, only one study in the US was conducted to investigate the correlation between hypertension risk and Life’s Simple 7 score (LS7), a metric developed by the American Heart Association to measure CVH. The aforementioned study investigated only Black adults and used a blood pressure of 140/90 mm Hg as the threshold for hypertension. Therefore, the current cohort study aimed to study both White and Black adults, and use a hypertension threshold of 130/80 mm Hg, as defined by the American Heart Association in 2017. Individuals on hypertension medication were also grouped as meeting this threshold. In the study, CVH was determined using the LS7 score, which measures body mass index, physical activity, diet, cigarette smoking, blood pressure, cholesterol levels, and glucose levels. Each factor was given a score of 0, 1, or 2, so that an LS7 score of 14 would indicate the best CVH. Overall, there were 2,930 participants in the study, 20% Black. When first enrolled between 2003 and 2007, all participants had normal blood pressure. At the follow-up between 2013 and 2016, 41% had developed hypertension (52% and 50% incidence for Black women and men, 37% and 42% incidence for White women and men). After controlling for all covariates, a 1-point increase in LS7 score was associated with 6% lower risk for hypertension (Risk Ratio 0.94, 95% CI 0.92-0.96). As well, no significant differences were found when categorizing by race or sex (P = 0.18 and 0.14 respectively). In conclusion, improved CVH was found to lower risk of developing hypertension, which lends support to guidelines that use the components of the LS7 metric to prevent or mitigate hypertension.

Click to read the study in JAHA

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