American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.
American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.
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DOI：
10.1016/j.amjmed.2015.03.027
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Solomon SD
中科院分区：
文献类型：
--
作者：
Folsom AR;Shah AM;Lutsey PL;Roetker NS;Alonso A;Avery CL;Miedema MD;Konety S;Chang PP;Solomon SD
许多人可能低估了生活方式在避免心力衰竭中的作用。我们估计，如果中年人更遵守美国心脏协会关于吸烟、体重、体育活动、饮食、胆固醇、血压和血糖的生活简单7指南，是否与降低心力衰竭的终生风险和老年时更好地保存心脏结构和功能有关。我们研究了1987-89年间13462名年龄在45-64岁的成年人的社区研究队列中基于人群的动脉粥样硬化风险。从1987-89年的风险因素测量中，我们创建了一个简单生活7分（范围0-14,2分为理想，1分为中等，0分为差）。通过对2011年出院和死亡代码的监测，我们确定了2218例心力衰竭事件。此外，在2011- 2013年期间，我们对4855名无临床心血管疾病的参与者进行了超声心动图检查，量化了左室肥厚和舒张功能障碍。四分之一的参与者（25.5%）在85岁之前患上心力衰竭。然而，对于那些中年生活简单指数为10-14分（最佳）的人来说，这种终生心力衰竭的风险为14.4%，得分为5-9分（平均）的人为26.8%，得分为0-4分（不足）的人为48.6%。在没有临床心血管事件的人群中，在中年生活简单指数为7分的人群中，晚年左心室肥厚的发生率约为40%，舒张功能障碍的发生率约为60%。美国心脏协会制定的“简单生活7”指标在中年时期达到较高的成就，与一生中较低的心力衰竭发生率和较好的心脏结构和功能保存有关。
Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association’s Life’s Simple 7 guidelines -- on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose -- is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age. We studied the population-based Atherosclerosis Risk in Communities Study cohort of 13,462 adults aged 45-64 years in 1987-89. From the 1987-89 risk factor measurements, we created a Life’s Simple 7 score (range 0-14, giving 2 points for ideal, 1 point for intermediate, and 0 points for poor components). We identified 2,218 incident heart failure events using surveillance of hospital discharge and death codes through 2011. In addition, in 4,855 participants free of clinical cardiovascular disease in 2011-13, we performed echocardiography from which we quantified left ventricular hypertrophy and diastolic dysfunction. One in four participants (25.5%) developed heart failure through age 85. Yet, this lifetime heart failure risk was 14.4% for those with a middle-age Life’s Simple 7 score of 10-14 (optimal), 26.8% for a score of 5-9 (average), and 48.6% for a score of 0-4 (inadequate). Among those with no clinical cardiovascular event, the prevalence of left ventricular hypertrophy in late life was approximately 40% as common, and diastolic dysfunction was approximately 60% as common, among those with an optimal middle-age Life’s Simple 7 score compared with an inadequate score. Greater achievement of American Heart Association’s Life’s Simple 7 in middle-age is associated with a lower lifetime occurrence of heart failure and greater preservation of cardiac structure and function.