Greater Adherence to Life's Simple 7 Is Associated With Less Arterial Stiffness: the Atherosclerosis Risk in Communities (ARIC) Study

Am J Hypertens. 2019 Jul 17;32(8):769-776. doi: 10.1093/ajh/hpz057.


Background: Greater arterial stiffness is associated independently with increased cardiovascular disease risk. The American Heart Association (AHA) has recommended following "Life's Simple 7 (LS7)" to optimize cardiovascular health; we tested whether better LS7 in middle age is associated with less arterial stiffness in later life.

Methods: We studied 4,232 black and white participants aged 45-64 years at the baseline (1987-89) visit of the Atherosclerosis Risk in Communities Study cohort who also had arterial stiffness measured in 2011-13 (mean ± SD interval: 23.6 ± 1.0 years). We calculated a 14-point summary score for baseline LS7 and classified participants as having "poor" (0-4), "average" (5-9), or "ideal" (10-14) cardiovascular health. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CI) for arterial stiffening: a high carotid-femoral pulse wave velocity (cfPWV, ≥13.23 m/s) or a high central pulse pressure (central PP, ≥ 82.35 mm Hg).

Results: The age, race, sex, and heart rate-adjusted ORs (95% CI) for high cfPWV in the "ideal," "average," and "poor" LS7 summary categories were 1 (Reference), 1.30 (1.11, 1.53), and 1.68 (1.10,2.56), respectively (P-trend = 0.0003). Similarly, the adjusted ORs (95% CI) for high central PP across LS7 summary categories were 1 (Reference), 1.48 (1.27, 1.74), and 1.63 (1.04, 2.56), respectively (P-trend <0.0001).

Conclusion: Greater LS7 score in middle age is associated with less arterial stiffness 2-3 decades later. These findings further support the AHA recommendation to follow LS7 for cardiovascular disease prevention.

Keywords: Atherosclerosis Risk in Communities Study; Life’s Simple 7; arterial elasticity; blood pressure; central pulse pressure; hypertension; pulse wave velocity.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Female
  • Health Behavior
  • Health Status
  • Healthy Lifestyle*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Primary Prevention*
  • Prospective Studies
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • United States / epidemiology
  • Vascular Stiffness*