From the Journals

Meeting just 2 of 7 ‘simple’ goals lowers HF risk

View on the News

Life’s Simple 7 goals are crucial and need support
Dr. Christie M. Ballantyne, Baylor College of Medicine, Houston

Dr. Christie M. Ballantyne

Soon, heart failure – which continues to have a poor prognosis – may become the most common cardiovascular disease. No preventive drugs are available, so prevention via other strategies is especially crucial. The results of this study are expected and in line with previous research. But they’re still important since they include a younger and larger population than previous studies examining the effectiveness of the American Heart Association’s Life’s Simple 7 strategies. The new report has limitations, including a small percentage of patients who developed HF, incomplete analysis of glucose levels and lack of ethnic diversity. Going forward, it’s important to remember the value of Life’s Simple 7 and the importance of supporting these metrics via multiple fronts such as public policy and education.

Christie M. Ballantyne, MD, and Vijay Nambi, MD, PhD, of Baylor College of Medicine, Houston, made these comments in an accompanying editorial. Dr. Ballantyne discloses grant/research support/consulting for Abbott and Roche and a provisional patent. Dr. Nambi discloses research site primary investigator work for Merck and a provisional patent.



Turns out the American Heart Association is onto something when it urges people to embrace its “Life’s Simple 7” (LS7) recommendations, a series of strategies designed to boost cardiovascular health. A new European study finds that people who follow the recommendations were more than half as likely to develop heart failure (HF) and that mastering just two of the seven criteria makes a big difference, compared with mastering none at all.

cigars and tape measure Ivan Mateev/iStockphoto

“Focusing on particular components of the American Heart Association LS7 could be seen as a way to improve cardiovascular health,” wrote the authors of the study, which appears in JACC: Heart Failure.

The LS7 encourages the following strategies:

  • Manage blood pressure.
  • Control cholesterol.
  • Reduce blood sugar.
  • Get active.
  • Eat better.
  • Lose weight.
  • Stop smoking.

For the new study, researchers led by Alicia Uijl, MSc, of University College London and University Medical Center Utrecht (the Netherlands) retrospectively tracked 37,803 participants in a prospective Dutch study of cancer and nutrition.

The subjects, 75% women, had a mean age of 49 years. The group was much thinner, with a mean body mass index of 25 kg/m2, than typical American men and women, whose mean BMIs are 29 and 30, per CDC statistics (Natl Health Stat Report. 2018 Dec;122:1-16)

Researchers gave the subjects an LS7 score (0-14) at baseline from 1993-1997. The score was based on whether they fully (2 points), partially (1) or not at all (0) met each of the LC7 criteria.

Most of the subjects failed to reach the ideal level of healthiness, which was defined as scores 11-14 and was achieved by 23%. The others were in the intermediate group (scores, 9-10 points; 35%) and inadequate group (scores, 0-8; 42%).

Over a median follow-up of 15 years, 2% of participants (690) developed HF. In an adjusted model, subjects in the top two groups (ideal and intermediate) were less likely to develop HF than were those in the lowest group (hazard ratios, 0.45 and 0.53, respectively).

The researchers found that diet, exercise, and cholesterol had lesser impacts on risk of HF than did the other elements. And they discovered that meeting the ideal level for just 2 of the 7 strategies would lower HF risk by 52%, compared with reaching no ideal levels.

What now? The high number of subjects in the lowest category suggests “there is ample room for improvements in healthy lifestyle behavior that may reduce HF in the general population,” the researchers wrote. “Given the robust associations between a healthy lifestyle and reduced incidence of HF, this study provides evidence that prevention of incident HF could be accomplished by implementing healthy lifestyle patterns.”

The study is funded by the European Commission, European Union/European Federation of Pharmaceutical Industries and Associations, and several other research organizations. The study authors reported no relevant disclosures.

SOURCE: Uijl A et al. JACC: Heart Fail. 2019 Jul 10. doi: 10.1016/j.jchf.2019.03.009

Recommended Reading

Pivotal trial shows HFrEF benefits from baroreceptor stimulation
MDedge Cardiology
Which antidiabetic for elderly patients? It depends on their CV risk
MDedge Cardiology
Elevated monocyte count predicts poor outcomes in idiopathic pulmonary fibrosis
MDedge Cardiology
Medicare may best Medicare Advantage at reducing readmissions
MDedge Cardiology
Higher omega-3 fatty acid levels cut heart failure risk
MDedge Cardiology