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Understanding the Association between Ideal Cardiovascular Health Metrics (American Heart Association’s Life Simple 7) and Subclinical Atherosclerosis in Midlife Women

Gibbs, Lauren (2022) Understanding the Association between Ideal Cardiovascular Health Metrics (American Heart Association’s Life Simple 7) and Subclinical Atherosclerosis in Midlife Women. Master Essay, University of Pittsburgh.

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Background: Carotid plaques are indicators of atherosclerosis and can cause adverse cardiovascular events, including strokes. The American Heart Association (AHA) created the Life Simple 7 (LS7) scoring criteria to measure modifiable risk factors that impact cardiovascular health. There is limited research on how the LS7 impact the development of carotid plaque in women during midlife, a time of accelerating cardiovascular disease risk. We hypothesize that midlife women who meet more LS7 criteria, a healthier cardiovascular health profile, will have less carotid plaque burden.
Methods: This cross-sectional analysis included 304 non-smoking women from the menopausal hot flashes and cardiovascular health (MsHeart) study. Carotid ultrasound scans were completed to assess plaque burden (area, height, number, and echogenicity). Each woman underwent assessments for diet, physical activity, blood pressure, body mass index, glucose and lipids. These seven factors were considered as LS7 components. For each factor women were given a score of 0,1, or 2 depending on if they met poor, intermediate, or ideal criteria. Each LS7 component score was then summed into an overall LS7 score (0-14) and ideal LS7 score (0-7). Regressions models were conducted between the summed overall and ideal LS7 component scores and measures of plaque burden and adjusted for race/ethnicity, age, education, and financial strain.
Results: Participants (mean age 54 years; 72% white and 22% Black) had a median and inter quartile range for the overall and ideal LS7 scores of 9.0(8.0, 10.0) and 3.0(2.0,4.0), respectively. Both overall and ideal LS7 scores were associated with less total plaque. Each unit increase of overall LS7 score was associated with a statistically significant 7-8% decrease in total plaque area and around a 0.06 mm decrease in maximum plaque height (both p<0.05). Lastly, overall LS7 score was significantly associated with average gray scale median.
Conclusion: Our findings indicate that a higher AHA LS7 score is associated with less carotid plaque burden in midlife women. The public health relevance of this study is that midlife is a time of increasing CVD risk for women and understanding how the LS7 components lessen carotid plaque burden could ultimately inform prevention efforts for adverse CVD outcomes.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Gibbs, Laurenlag169@pitt.edulag169
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairBarinas-Mitchell, Emmaejb4@pitt.eduejb4UNSPECIFIED
Committee MemberThurston, Rebeccathurstonrc@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberSekikawa, Akiraakira@pitt.eduakiraUNSPECIFIED
Date: 17 May 2022
Date Type: Completion
Submission Date: 26 April 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 61
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Life Simple 7, Carotid Plaque, Subclinical Atherosclerosis, Midlife Women
Date Deposited: 17 May 2022 15:33
Last Modified: 17 May 2024 05:15


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