Life’s Simple 7, an assessment tool from the American Heart Association, has proven to be an effective way to track the population’s cardiovascular health in an effort to improve outcomes by 2020. A new study, published in the Journal of the American Heart Association, from a team led by UVM Postdoctoral Fellow Nels Olson, Ph.D. ’11, has shown that a favorable Life’s Simple 7 status also is related to decreased risk from another dangerous but less well-known threat: Venous thromboembolism (VTE).

Developed in 2010, Life’s Simple 7 measures seven factors, including body mass index (BMI), blood pressure (BP), cholesterol, glucose, physical activity, cigarette smoking and diet. The goal is to improve the cardiovascular health of all Americans by 20 percent and reduce deaths from cardiovascular diseases (CVD) and stroke by 20 percent, nationally by 2020. Tracking these metrics at a population level can help determine whether prevention efforts are effective.

“What these seven metrics have in common is that they have all been linked to cardiovascular disease,” Olson says. “And they’re modifiable – they can be changed.”

Olson wanted to apply these same metrics to VTE: A condition that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). Both result from a blood clot that forms in a vein deep inside the body, and in the case of PE, travels to the lungs, often resulting in severe damage or death. Do these same metrics that reduce the risk of cardiovascular disease (CVD) and stroke also reduce the risk of VTE? There’s some evidence that CVD and VTE risk factors are shared, Olson says, but overall the data are far from conclusive. This study aims to start to fill that gap.

“There’s been a lot of great progress in reducing the risk of CVD,” he says, “but little to reduce the risk of VTE at a population level.”

Olson’s team based its work on data from over 30,000 participants aged 45 and older from every state in the contiguous U.S., a “fascinating cohort,” Olson says, that has already proven useful in studying the effect of Life’s Simple 7 on cognitive impairment and stroke outcomes.

Participants who had not had any VTE events at the time of enrollment were tracked for an average of five years. There were 263 participants who suffered a VTE during the study, and after crunching the numbers from this group and those who suffered no VTE, Olson’s team found that favorable Life’s Simple 7 scores did correlate with lower risk of VTE by a significant margin.

Olson gave each participant a score of zero to two points for each of the seven health components. For example, a BMI of 30 or higher, which is considered obese, received zero points, whereas a BMI of less than 25, considered normal, received two points. Scores from the seven components were added together and used to group the participants into 3 health categories, “inadequate” (0-4 points), “average” (5-9 points), and “optimal” (10-14 points). Olson found that scores in the “adequate” category correlated with a 38 percent lower risk of VTE, and scores in the “optimal” category correlated with a 44 percent lower risk of VTE. Out of the seven individual components, obesity’s relationship to VTE risk is perhaps the most well-documented, Olson notes. His results followed suit, showing ideal BMI resulted in a 66 percent lower VTE risk. Why obesity is such a risk factor for VTE needs to be explored further, Olson says.

Another finding of note: The “strong relationship” between physical activity and lower VTE risk. This is a novel finding, Olson says, with further studies needed to more firmly establish this correlation. If lack of physical activity can be established as a VTE risk factor, public health policy makers, health care providers, and patients may have another strategy to reduce VTE risk, one that has already proven useful for cardiovascular disease and stroke: Regular exercise.

With VTE the third most common cause of cardiovascular illness, after acute coronary syndrome and stroke, the study stands to help shape public health policy as well as patients’ approach to managing their health.

“We are learning how to promote healthy lifestyles and lifestyle interventions at a population level,” says Olson, “and are continuing to raise awareness around VTE.”

Additional authors from UVM on the study include Mary Cushman, M.D., M.Sc.; Susan Lakoski, M.D.; and Neil Zakai, M.D., M.Sc.

 

PUBLISHED

04-27-2015
Erin E Post