Abstract P256: Better Mid-life Life’S Simple 7 Status is Associated With Lower Risk of Recurrent Cardiovascular Disease and All-cause Mortality After Stroke: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Cardiovascular disease (CVD), including stroke, is a leading cause of morbidity and mortality. Ideal levels of the American Heart Association’s Life’s Simple 7 (LS7) metric are associated with lower stroke risk. However, the association between LS7 and recurrent CVD and mortality after incident stroke is unclear. Hypothesis: Stroke survivors with higher LS7 scores before incident stroke would have lower risk of recurrent CVD and mortality than those with lower scores. Methods: From 14715 individuals free of stroke at ARIC baseline (1987-1989), we analyzed data on 1380 participants who had an incident stroke between 1987-2017. A summary baseline LS7 score (range: 0-14) was derived by assigning 2 points for ideal, 1 point for intermediate, and 0 points for poor on each of the following: smoking, adiposity, physical activity, diet, total cholesterol, blood pressure and fasting glucose at baseline. We calculated adjusted hazard ratios (HR) for a composite and individual CVD outcomes of recurrent stroke, myocardial infarction, heart failure, and all-cause mortality after incident stroke, per a priori categories in baseline LS7 score. Results: At baseline, the mean age of participants with incident stroke was 55.7 ± 5.6 years (53% women, 36% black). Participants with the highest LS7 scores (≥10, n= 3287) had 66% lower risk (HR: 0.34, 95% CI: 0.29-0.40) of incident stroke than those with intermediate cardiovascular (CV) health (4-6, n=4166) ( Table ). During a median (SE) follow-up of 7.5 (0.45) years, 42.5% (587/1380) had recurrent composite CVD after incident stroke. LS7 score at baseline (before incident stroke) was inversely associated with recurrent CV outcomes (composite, myocardial infarction, heart failure) and all-cause mortality after incident stroke but not recurrent stroke (Table) . Conclusions: Better CV health in mid-life before incident stroke was associated with lower risk of recurrent CVD after stroke, suggesting that good CV health is essential for secondary prevention among stroke patients.