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Background  The American Heart Association has defined metrics of ideal cardiovascular health known as Life's Simple 7 ( LS 7) to prevent cardiovascular disease. We examined the association between  LS 7 and incident atrial fibrillation ( AF ) in a biracial cohort of middle‐ and older‐aged adults without known cardiovascular disease.    Methods and Results  This analysis included 13 182 ARIC (Atherosclerosis Risk in Communities) study participants (mean baseline age=54±5.7 years; 56% women; 25% black) free of  AF  and cardiovascular disease. An overall  LS 7 score was calculated as the sum of the  LS 7 component scores and classified as inadequate (0‐4), average (5‐9), or optimal (10‐14) cardiovascular health. The primary outcome was incident  AF , identified primarily by ECG and hospital discharge coding of  AF  through December 31, 2014. A total of 2266 (17%) incident  AF  cases were detected over a median follow‐up of 25.1 years. Compared with the inadequate category (n=1057), participants in the average (n=8629) and optimal (n=3496) categories each had a lower risk of developing  AF  in a multivariable Cox proportional hazards model (hazard ratio 0.59, 95% confidence interval 0.51, 0.67 for average; and hazard ratio 0.38, 95% confidence interval 0.32, 0.44 for optimal). In a similar model, a 1‐point‐higher  LS 7 score was associated with a 12% lower risk of incident  AF  (hazard ratio 0.88, 95% confidence interval 0.86, 0.89).    Conclusions  A higher  LS 7 score is strongly associated with a lower risk of  AF  in individuals without baseline cardiovascular disease. Determining whether interventions that improve the population's cardiovascular health also reduce  AF  incidence is needed.

journal of the american heart association

American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study