Abstract
Introduction: The AHA’s Life’s Simple 7 (LS7) includes physical activity (PA) as one of the metrics for assessing cardiovascular health. Using self-reported PA can misclassify those who meet the PA component of the LS7. Using accelerometer-measured PA may improve the utility of the LS7. Our study compares associations of LS7 and incident cardiovascular disease (CVD) associations using both self-reported and accelerometer-measured PA. Methods: Women’s Health Initiative (WHI) participants in the Objective Physical Activity and Cardiovascular Health Study (n=4075; mean±SD age = 79±7) with no history of CVD completed the WHI PA questionnaire (PAQ) and the Community Healthy Activities Model Program for Seniors (CHAMPS) PAQ prior to wearing a hip-worn accelerometer for up to 7 consecutive days. LS7 components (PA, diet, body mass index, smoking, blood pressure, fasting serum total cholesterol and glucose) were scored on a scale of 0-2 using AHA guidelines, resulting in an LS7 summary score ranging from 0-14 with higher scores reflecting more favorable status. Four LS7 summary scores were created using different PA measures: the WHI PAQ, the CHAMPS PAQ, and two accelerometer measures (MVPA min/week and mean steps/day). LS7 scores were analyzed using quartiles (LS7 scores 1-7, 8, 9, 10-14) and hazard ratios (HR) for incident physician-adjudicated CVD were estimated. Results: There were 500 incident CVD events (see Table) over an average 6 years of follow-up. Multivariable HRs (95% CI) comparing women with high (10-14) vs. low (1-7) LS7 scores were: WHI PAQ= 0.81 (0.60-1.09), CHAMPS PAQ= 0.80 (0.61-1.05), accelerometer (MVPA)= 0.61 (0.47-0.79), accelerometer (steps)= 0.65 (0.45-0.94; see Table). Conclusions: PA is just one component of the LS7, yet the LS7-incident CVD associations vary considerably by PA measurement. Accelerometer-measured PA, such as daily steps, improves the accuracy of the LS7 PA component used to classify cardiovascular health and may be feasible for practitioners to implement.
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