{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:39:01Z","timestamp":1790883541411,"version":"4.1.0"},"reference-count":56,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although sufficient and healthy sleep is inversely associated with cardiovascular disease (CVD) and its risk factors, the American Heart Association's Life's Simple 7 (LS7), as a measure of cardiovascular health (CVH), did not include sleep. We evaluated an expanded measure of CVH that includes sleep as an eighth metric in relation to CVD risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The analytic sample consisted of MESA (Multi\u2010Ethnic Study of Atherosclerosis) Sleep Study participants who had complete data on sleep characteristics from overnight polysomnography, 7\u2010day wrist actigraphy, validated questionnaires, and the outcome. We computed the LS7 score and 4 iterations of a new CVH score: score 1 included sleep duration, score 2 included sleep characteristics linked to CVD in the literature (sleep duration, insomnia, daytime sleepiness, and obstructive sleep apnea), scores 3 and 4 included sleep characteristics associated with CVD in MESA (score 3: sleep duration and efficiency, daytime sleepiness, and obstructive sleep apnea; score 4: score 3+sleep regularity). Multivariable\u2010adjusted logistic and Cox proportional hazards models evaluated associations of the LS7 and CVH scores 1 to 4 with CVD prevalence and incidence. Among 1920 participants (mean age: 69\u00b19\u2009years; 54% female), there were 95 prevalent CVD events and 93 incident cases (mean follow\u2010up, 4.4\u2009years). Those in the highest versus lowest tertile of the LS7 score and CVH scores 1 to 4 had up to 80% lower odds of prevalent CVD. The LS7 score was not significantly associated with CVD incidence (hazard ratio, 0.62 [95% CI, 0.37\u20131.04]). Those in the highest versus lowest tertile of CVH score 1, which included sleep duration, and CVH score 4, which included multidimensional sleep health, had 43% and 47% lower incident CVD risk (hazard ratio, 0.57 [95% CI, 0.33\u20130.97]; and hazard ratio, 0.53 [95% CI, 0.32\u20130.89]), respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">CVH scores that include sleep health predicted CVD risk in older US adults. The incorporation of sleep as a CVH metric, akin to other health behaviors, may enhance CVD primordial and primary prevention efforts. Findings warrant confirmation in larger cohorts over longer follow\u2010up.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.025252","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T10:55:52Z","timestamp":1666176952000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":130,"title":["Redefining Cardiovascular Health to Include Sleep: Prospective Associations With Cardiovascular Disease in the MESA Sleep Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5230-8689","authenticated-orcid":false,"given":"Nour","family":"Makarem","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Heath Columbia University Irving Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3650-4684","authenticated-orcid":false,"given":"Cecilia","family":"Castro\u2010Diehl","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women\u2019s Hospital and Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1354-1749","authenticated-orcid":false,"given":"Marie\u2010Pierre","family":"St\u2010Onge","sequence":"additional","affiliation":[{"name":"Department of Medicine Columbia University Irving Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6585-1610","authenticated-orcid":false,"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women\u2019s Hospital and Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7382-0603","authenticated-orcid":false,"given":"Steven","family":"Shea","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Heath Columbia University Irving Medical Center New York NY"},{"name":"Department of Medicine Columbia University Irving Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-6110","authenticated-orcid":false,"given":"Donald","family":"Lloyd\u2010Jones","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Feinberg School of Medicine Northwestern University Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Feinberg School of Medicine Northwestern University Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6199-864X","authenticated-orcid":false,"given":"Brooke","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Medicine Columbia University Irving Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000677"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_3_2_4_2","volume-title":"Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem","author":"Institute of Medicine Committee on Sleep Medicine and Research","year":"2006","unstructured":"Institute of Medicine Committee on Sleep Medicine and Research . 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