Sociodemographic determinantS

Life’s Simple 7 (LS7), developed by the American Heart Association to track and improve cardiovascular health from 2010 to 2020, 2030 and beyond,1,2 consists of seven variables: nutrition, physical activity, cigarette use, body mass index (BMI), blood pressure (BP), cholesterol and glucose. Healthy People 2020 identified the same seven items to reduce cardiovascular disease (CVD) events by 20%, and Million Hearts 2022 selected similar variables to prevent 1 million CVD events.3,4 Thus, consensus exists on modifiable behavioral and biometric variables to improve cardiovascular health. Each LS7 item defines levels of ideal, intermediate and poor cardiovascular health. Among adults initially free of CVD, those with ideal rather than poor LS7 scores are less likely to develop hypertension, type 2 diabetes (T2D), coronary heart disease, heart failure, atrial fibrillation, and stroke.5–11 Higher LS7 scores predict less chronic disease in other health domains,12 which also links LS7 with non-cardiovascular health. When cardiovascular risk factors are treated and controlled, excess residual risk persists compared with individuals without risk factors.13 More prevalent hypertension and T2D in non-Hispanic Black (NHB) than non-Hispanic White (NHW) adults precludes equivalent CVD outcomes, even with identical risk factor control. Cardiovascular health equity requires a greater focus on preventing CVD Sociodemographic determinantS of Life’S SimpLe 7: impLicationS for achieving cardiovaScuLar heaLth and heaLth equity goaLS