TY - JOUR
T1 - Change in Life's Simple 7 Measure of Cardiovascular Health After Incident Stroke
T2 - The REGARDS Study
AU - Liu, Chelsea
AU - Roth, David L.
AU - Gottesman, Rebecca F.
AU - Sheehan, Orla C.
AU - Blinka, Marcela D.
AU - Howard, Virginia J.
AU - Judd, Suzanne E.
AU - Cushman, Mary
N1 - Funding Information:
This research project is supported by a cooperative agreement U01 NS041588 cofunded from the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute of Aging (NIA), National Institutes of Health, Department of Health and Human Service. Additional funding was provided by an investigator-initiated grant (R01 NS075047) from NINDS. The content is solely the responsibility of the authors and does not necessarily represent the official views of NINDS or the National Institutes of Health. Representatives of the funding agency have been involved in the review of the article but not directly involved in the collection, management, analysis, or interpretation of the data. Dr Gottesman is supported by a grant from the National Institute on Aging (K24AG052573).
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Background and Purpose: Life's Simple 7 (LS7) is a metric for cardiovascular health based on the 7 domains of smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. Because they may be targeted for secondary prevention purposes, we hypothesized that stroke survivors would experience improvement in LS7 score over time compared with people who did not experience a stroke. We addressed this hypothesis in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) cohort of Black and White adults enrolled between 2003 and 2007. Methods: Participants who had LS7 data at baseline, were stroke-free at baseline, had a 10-year follow-up visit, and either did not have a stroke or had an ischemic stroke >1 year before follow-up were included (N=7569). Among these participants, 149 (2.0%) had an adjudicated ischemic stroke between the LS7 assessments. LS7 scores were classified as 0 to 2 points for each domain for a maximum score of 14, with higher scores representing better health. Multivariable linear regression was used to test the association of ischemic stroke with change in LS7 score. Covariates included baseline LS7 score, age, race, sex, education, and geographic region. Results: The 149 stroke survivors had an average of 4.9 years (SD=2.5) of follow-up from the stroke event to the second LS7 assessment. After adjusting for covariates, participants who experienced an ischemic stroke showed 0.28 points more decline in total LS7 score (P=0.03) than those who did not experience a stroke. Conclusions: Stroke survivors did not experience improvements in cardiovascular health due to secondary prevention after ischemic stroke. On the contrary, they experienced significantly greater decline, indicating the need for greater efforts in secondary prevention after a stroke.
AB - Background and Purpose: Life's Simple 7 (LS7) is a metric for cardiovascular health based on the 7 domains of smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. Because they may be targeted for secondary prevention purposes, we hypothesized that stroke survivors would experience improvement in LS7 score over time compared with people who did not experience a stroke. We addressed this hypothesis in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) cohort of Black and White adults enrolled between 2003 and 2007. Methods: Participants who had LS7 data at baseline, were stroke-free at baseline, had a 10-year follow-up visit, and either did not have a stroke or had an ischemic stroke >1 year before follow-up were included (N=7569). Among these participants, 149 (2.0%) had an adjudicated ischemic stroke between the LS7 assessments. LS7 scores were classified as 0 to 2 points for each domain for a maximum score of 14, with higher scores representing better health. Multivariable linear regression was used to test the association of ischemic stroke with change in LS7 score. Covariates included baseline LS7 score, age, race, sex, education, and geographic region. Results: The 149 stroke survivors had an average of 4.9 years (SD=2.5) of follow-up from the stroke event to the second LS7 assessment. After adjusting for covariates, participants who experienced an ischemic stroke showed 0.28 points more decline in total LS7 score (P=0.03) than those who did not experience a stroke. Conclusions: Stroke survivors did not experience improvements in cardiovascular health due to secondary prevention after ischemic stroke. On the contrary, they experienced significantly greater decline, indicating the need for greater efforts in secondary prevention after a stroke.
KW - blood pressure
KW - epidemiology
KW - life style
KW - risk factors
KW - secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85102218497&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85102218497&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.120.030836
DO - 10.1161/STROKEAHA.120.030836
M3 - Article
C2 - 33467879
AN - SCOPUS:85102218497
SN - 0039-2499
VL - 52
SP - 878
EP - 886
JO - Stroke
JF - Stroke
IS - 3
ER -