Stroke：生活方式7项简易评分可较好预测卒中风险

健康的生活方式有助于预防卒中，美国心脏协会制定了生活方式7项简易评分(LS7)用于预测心血管病的风险。来自美国的Ambar Kulshreshtha等医师研究了包括血压、胆固醇、血糖、体重指数、吸烟情况、身体活动及饮食在内的七个方面对卒中的影响情况，在线发表在2013年6月6日的stroke杂志上。该研究旨在评价LS7评分美国白人和黑人卒中风险的预测。研究发现：7项生活方式简易评分可较好预测卒中风险。

卒中的地域和种族差异原因研究是一项全国基于30239例包括白人和黑人，年龄大于或等于45岁人人群研究，样本来源于2003年至2007年的美国人群。通过电话访问、调查表调查及家庭查体的方式获取数据。卒中发病率的识别通过每年两次随访患者的病例资料获得。生活方式7项评价包括7个部分：血压、胆固醇、血糖、体重指数、吸烟情况、身体活动及饮食七个方面，每项分为较差（0分）、中等（1分）及理想（2分）健康方式三级。总的LS7评分分为差(0–4)，平均(5–9)，最佳(10–14)三种心血管健康生活方式。

在22914例有LS7数据及没有心血管疾病的研究人群众，有432例在平均4.9年的随访期内发生卒中。在调整人口差异、经济社会状态差异及地区差异后，LS7评分中每种健康生活方式平均降低25%（危险比为0.75; 95%可信区间0.63–0.90）卒中风险。白人与黑人间没有明显不同（交互P值为0.55）。LS7评分每增高一分，卒中的风险下降8%（危险比0.92; 95%可信区间0.88–0.95）。

研究结果显示：无论在白人还是在黑人中，基于LS7评分获得的健康心血管生活方式与降低卒中风险相关，微小的评分不同都是卒中的重要决定因素。

Life’s Simple 7 and Risk of Incident Stroke
The Reasons for Geographic and Racial Differences in Stroke Study
Background and Purpose
The American Heart Association developed Life’s Simple 7 (LS7) as a metric defining cardiovascular health. We investigated the association between LS7 and incident stroke in black and white Americans.
Methods
The Reasons for Geographic And Racial Differences in Stroke (REGARDS) is a national population-based cohort of 30 239 blacks and whites, aged ≥45 years, sampled from the US population from 2003 to 2007. Data were collected by telephone, self-administered questionnaires, and an in-home examination. Incident strokes were identified through biannual participant contact followed by adjudication of medical records. Levels of the LS7 components (blood pressure, cholesterol, glucose, body mass index, smoking, physical activity, and diet) were each coded as poor (0 point), intermediate (1 point), or ideal (2 points) health. An overall LS7 score was categorized as inadequate (0–4), average (5–9), or optimum (10–14) cardiovascular health.
Results
Among 22 914 subjects with LS7 data and no previous cardiovascular disease, there were 432 incident strokes over 4.9 years of follow-up. After adjusting for demographics, socioeconomic status, and region of residence, each better health category of the LS7 score was associated with a 25% lower risk of stroke (hazard ratios, 0.75; 95% confidence interval, 0.63–0.90). The association was similar for blacks and whites (interaction P value=0.55). A 1-point higher LS7 score was associated with an 8% lower risk of stroke (hazard ratios, 0.92; 95% confidence interval, 0.88–0.95).
Conclusions
In both blacks and whites, better cardiovascular health, on the basis of the LS7 score, is associated with lower risk of stroke, and a small difference in scores was an important stroke determinant.