Association Between Life’s Simple 7 and Biomarkers of Cardiovascular Disease: Aldosterone, Interleukin-6, C-Reactive Protein

Abstract

BACKGROUND: To promote ideal cardiovascular health, the American Heart Association recommends adhering to Life’s Simple 7 (LS7)—achieving healthy targets for body mass index, physical activity, dietary intake, blood pressure, fasting plasma glu-cose, and cholesterol, along with smoking abstinence. Poorer achievement of LS7 (lower score) has been associated with the development of hypertension and cardiovascular disease. However, less is known about the associations between LS7 and specific biomarkers linked to cardiovascular health: aldosterone, CRP (C-reactive protein), and IL-6 (interleukin-6). METHODS AND RESULTS: We analyzed 379 individuals (age 18–66 years) from the HyperPATH (International Hypertensive Pathotype), who were maintained on ≥200 mEq of sodium daily for 1 week. We calculated a 14-point summative LS7 score according to participants’ baseline data. Based on the range of LS7 score in this population (3–14), we classified participants as “inadequate” (3–6), “average” (7–10), and “optimal” (11–14). Regression analyses found that a higher LS7 score group was associated with lower levels of serum and urinary aldosterone (Ptrend <0.001 and Ptrend =0.001, respectively), lower plasma renin activity (Ptrend <0.001), and a blunted increase in serum aldosterone with angiotensin II infusion (Ptrend =0.023). Being in the “op-timal” LS7 score group was associated with lower serum CRP (Ptrend =0.001) and IL-6 (Ptrend =0.001). CONCLUSIONS: A higher LS7 score was associated with a lower activity of the renin-angiotensin-aldosterone system and lower levels of the inflammatory markers CRP and IL-6. These findings offer a possible link between ideal cardiovascular health targets and biomarkers known to play a central role in the development of cardiovascular disease.