Association of Life's Simple 7 with Atrial Fibrillation Burden (From the Atherosclerosis Risk in Communities Study)

• Type of Material: Article
• Authors: Wendy Wang, University of Minnesota, Minneapolis; Faye L Norby, University of Minnesota, Minneapolis; Mary R Rooney, University of Minnesota, Minneapolis; Michael Zhang, University of Minnesota, Minneapolis; Alejandra Gutierrez, University of Minnesota, Minneapolis; Parveen Garg, University of Southern California; Elsayed Z Soliman, Wake Forest University; Alvaro Alonso, Emory University; Samuel C Dudley, University of Minnesota, Minneapolis; Pamela L Lutsey, Univ Minnesota; Lin Y Chen, University of Minnesota, Minneapolis
• Language: English
• Date: 2020-12-15
• Publisher: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amjcard.2020.09.033
• Title of Journal or Parent Work: AMERICAN JOURNAL OF CARDIOLOGY
• Volume: 137
• Start Page: 31
• End Page: 38
• Grant/Funding Information: This work was also supported by grants from the National Heart Lung and Blood Institute [R01HL126637-01A1 (LYC), R01HL141288 (LYC), K24HL14852 (AA)] and the American Heart Association [16EIA26410001 (AA)].; The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I).
• Keywords: Cardiovascular System & Cardiology; Science & Technology; Life Sciences & Biomedicine; REDUCTION; SURVIVAL; DIABETES-MELLITUS; TERM; MANAGEMENT; Cardiac & Cardiovascular Systems; HEART-FAILURE; COHORT; GOAL; FOLLOW-UP

Abstract

The American Heart Association's Life's Simple 7 (LS7) metric consists of 7 modifiable risk factors. Although a more favorable LS7 risk factor profile is associated with lower AF incidence, this relation is unknown in regard to AF burden. We assessed the prospective association of overall LS7 score and individual LS7 risk factors in midlife with AF burden in late-life in the Atherosclerosis Risk in Communities Study. LS7 components were assessed at Visit 3 (1993 to 1995) and a composite score ranging from 0 to 14 was calculated. A higher score indicates better cardiovascular health. AF burden was measured at Visit 6 (2016 to 2017) with a 2-week Zio XT Patch. AF burden, defined as the percent of time a participant was in AF, was categorized as none, intermittent (>0 to <100%), or continuous (100%). Weighted multinomial logistic regression was used. Of the 2,363 participants, 58% were female and 24% were black. Participants were aged 57 ± 5 years at Visit 3 and 79 ± 5 years at Visit 6. From the Zio XT Patch, 5% had continuous AF, 4% had intermittent AF, and 91% had none. After multivariable adjustment, each 1-point increase in LS7 score had 0.87 (95% CI: 0.79 to 0.95) higher odds of continuous AF than no AF. Individually, poor levels of physical activity, BMI, and fasting blood glucose were associated with greater AF burden. In conclusion, this population-based prospective cohort study reports that unfavorable cardiovascular health profile in midlife is associated with higher AF burden in late-life and future research to evaluate the effectiveness of optimizing physical activity, BMI, and fasting blood glucose in lowering AF burden is warranted.