Life's Simple 7 and the risk of atrial fibrillation: The Multi-Ethnic Study of Atherosclerosis

Oluseye Ogunmoroti, Erin D. Michos, Konstantinos N. Aronis, Joseph A. Salami, Ron Blankstein, Salim S. Virani, Erica S. Spatz, Norrina B. Allen, Jamal S. Rana, Roger S. Blumenthal, Emir Veledar, Moyses Szklo, Michael J. Blaha, Khurram Nasir

Research output: Contribution to journalArticlepeer-review

49 Citations (Scopus)


Background and aims: We examined the association between the American Heart Association's Life's Simple 7 (LS7) metrics and the risk of atrial fibrillation (AF) in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of adults free of cardiovascular disease (CVD) at baseline. Methods: We analyzed data from 6506 participants. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each categorized into ideal (assigned 2 points), intermediate (1 point) or poor (0 points). Scores were summed for a maximum of 14. A score of 0–8 was considered inadequate; 9-10, average and 11-14, optimal for cardiovascular health. Atrial fibrillation was ascertained using ICD-9 codes from hospital discharge records and Medicare claims data. Cox proportional hazard ratios (HR) and incidence rates of AF per 1000 person-years were calculated. Results: During a median follow-up of 11.2 years (interquartile range: 10.6–11.7 years), 709 (11%) participants were hospitalized with a first AF episode. In the overall cohort, optimal scores at baseline were associated with a 27% lower risk for AF compared with inadequate scores (0.73 [0.59–0.91]). A similar finding was observed when the results were stratified by race/ethnicity (White, Chinese American, African American and Hispanic), though many of the associations were not statistically significant. There was no interaction by race/ethnicity (p = 0.15). Conclusions: In the overall cohort, optimal LS7 status was associated with a lower risk of AF. These findings suggest that promoting ideal cardiovascular health may reduce the incidence and burden of AF.

Original languageEnglish
Pages (from-to)174-181
Number of pages8
Publication statusPublished - Aug 2018
Externally publishedYes


  • Atrial fibrillation
  • Ideal cardiovascular health metrics
  • Life's Simple 7
  • Prevention


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