Maintaining ideal cardiovascular health using Life’s Simple 7 metrics was associated with up to an 86% lower risk of dementia and significantly reduced rates of chronic diseases and mortality, according to a recent study.
In a systematic review researchers conducted a comprehensive analysis of 483 studies published between January 1, 2010 to January 1, 2021, examining cardiovascular health (CVH) using the American Heart Association’s Life’s Simple 7 (LS7) metric. The LS7 construct comprises seven metrics: three health behaviors (diet, physical activity, and smoking) and four clinical factors (body mass index, blood pressure, cholesterol, and glucose). This review, aimed to evaluate the prevalence, determinants, outcomes, and biological mechanisms associated with CVH across the lifespan.
The researchers, led by Liliana Aguayo of the Emory Global Diabetes Research Center, Emory University Atlanta GA, and colleagues, systematically searched PubMed, Web of Science, and Scopus using predefined algorithms. Eligible studies assessed CVH using at least three LS7 components, and methodological quality was evaluated with a modified version of the Mixed Methods Appraisal Tool (MMAT). Among studies on prevalence, outcomes, and determinants, 84.5%, 86%, and 83% of the MMAT quality criteria were fulfilled, respectively, indicating overall low risk of bias.
Of the 483 included studies, 259 examined clinical outcomes, 84 assessed CVH prevalence, 99 evaluated determinants, 18 focused on interventions, and 23 explored biological mechanisms. Ideal or high CVH—defined as achieving 6 or more ideal LS7 metrics or a composite score 12 or more—was consistently associated with lower risk for numerous outcomes. Specifically, higher CVH was linked to 86% lower risk of dementia, 62% lower risk of chronic kidney disease, 20% lower risk of cancer, and a 10% lower risk of depression per each additional ideal metric. A 5-year period of ideal or intermediate CVH was associated with a 33% reduction in hypertension, 25% reductions in diabetes and CVD, and a 14% reduction in all-cause mortality.
Prevalence of ideal CVH was low globally, often ranging from 0% to 4%, with higher rates observed among youth. For example, a nationally representative sample in Nepal reported that 71.5% of youth aged 15 to 29 years had 5 to 7 ideal metrics, whereas U.S. data from 2011 showed only 15.3% of young White adults met this threshold. Disparities in CVH were evident by age, race, sex, geography, and social determinants of health.
This review documents a dose-dependent association between ideal CVH and a range of favorable health outcomes, supporting the importance of primordial prevention strategies to sustain CVH throughout the lifespan.
Full disclosures can be found in the published study.