Life simple seven (LS7) have been promoted by the American Heart Association as a tool to promote cardiovascular health in the population and track it over time. Some have advocated that this tool also represent an opportunity to focus in modifiable risk factors that can reduce the risk of cardiovascular disease. Evidence supporting the validity of the LS7 to identify those at risk of cardiovascular disease, particularly stroke, has been piling up. In this issue of Stroke, Cushman et al report that individuals from the REGARDS study who had the highest score (representing the healthier group) had the smallest risk of incident stroke while those in the lower end of the LS7 had the highest risk of stroke. The author identified a reduction of 8% in stroke risk per score point in the LS7. The risk of stroke was similar for White and Blacks in equal categories of LS7, although Blacks had a lower prevalence of cardiovascular health factors. Only minority had five or more ideal LS7: 3% of Whites and 8% of Blacks.
The results by Kulshreshtha et al. and those of other groups that have demonstrated the usefulness of the LS7 to measure cardiovascular health and to identify those at higher risk of vascular events shed a dire picture about the current status of ideal cardiovascular health in the US. At the same time, these results may bring a glimpse of hope to curb the vascular-related mortality and morbidity epidemic by focusing in promoting changes at a population levels. It is encouraging to see that a single point change in the score is associated with reduce stroke risk, so even a modest gain should be encouraged. From a public health perspective, investing resources in accomplishing a healthier lifestyle seems the smartest way to go in preventing vascular disease, particularly stroke.