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Abstract: TH-PO688

Life's Simple 7 and Risk of Cardiovascular Disease in the Chronic Renal Insufficiency Cohort

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Pike, Mindy, Vanderbilt University, Nashville, Tennessee, United States
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Lipworth, Loren, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Robinson-Cohen, Cassianne, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background

The American Heart Association (AHA) has identified seven modifiable factors, “Life’s Simple 7”, that contribute to heart health. The association between these ideal health behaviors and cardiovascular (CV) disease has not been examined among individuals with chronic kidney disease (CKD).

Methods

We studied 2,979 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study. The AHA definitions for non-ideal health were used for body mass index (BMI≥25kg/m2), total cholesterol (≥200 mg/dL), blood pressure (≥120 systolic and ≥80 diastolic), fasting plasma glucose (≥100 mg/dL), and physical activity (<75 min/week of vigorous physical activity or <150min/week of moderate/vigorous). Due to design constraints, modified definitions were used for smoking (current) and consuming an unhealthy diet (below median fruit and vegetables, fish, and whole grain intake, and above median urine sodium and sweetened beverage intake). The outcome was time to first adjudicated CV event, defined as heart failure, myocardial infarction, ischemic stroke, or death. Population attributable risk percent (PAR%) was estimated from Cox regression models including each Simple 7 factor, age, sex, race, income, education, family history of coronary artery disease, and estimated glomerular filtration rate.

Results

During a median follow-up of 7 years, 1,345 participants had an incident CV event (5.8/100 person-years). High fasting glucose contributed the most to CV burden, with a PAR of 20.1% (95% CI: 15.0-24.8). Physical underactivity, smoking, and high blood pressure accounted for a modest proportion of the population risk, while poor diet, BMI, and high cholesterol had nonsignificant PARs. In race-stratified analyses, high glucose remained the strongest contributor, but among white participants, physical underactivity also contributed significantly to risk (PAR: 17.6%; 95% CI: 9.2-25.2), while high blood pressure contributed significantly among blacks (PAR: 5.1%; 95% CI: 0.04-9.9).

Conclusion

Among individuals with CKD, high fasting glucose contributed the most to CV burden. Understanding the contributions of each modifiable risk factor may help target efforts to reduce CV incidence in this population.

Funding

  • NIDDK Support