Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study
Abstract Background The American Heart Association recently updated its construct of what constitutes cardiovascular health (CVH), called Life’s Essential 8. We examined the association of total and individual CVH metrics according to Life’s Essential 8 with all-cause and cardiovascular disease (CVD...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-023-02824-8 |
| _version_ | 1797853753291833344 |
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| author | Jiahong Sun Yanzhi Li Min Zhao Xiao Yu Cheng Zhang Costan G. Magnussen Bo Xi |
| author_facet | Jiahong Sun Yanzhi Li Min Zhao Xiao Yu Cheng Zhang Costan G. Magnussen Bo Xi |
| author_sort | Jiahong Sun |
| collection | DOAJ |
| description | Abstract Background The American Heart Association recently updated its construct of what constitutes cardiovascular health (CVH), called Life’s Essential 8. We examined the association of total and individual CVH metrics according to Life’s Essential 8 with all-cause and cardiovascular disease (CVD)-specific mortality later in life. Methods Data were from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 at baseline linked to the 2019 National Death Index records. Total and individual CVH metric scores including diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure were classified as 0–49 (low level), 50–74 (intermediate level), and 75–100 (high level) points. The total CVH metric score (the average of the 8 metrics) as a continuous variable was also used for dose–response analysis. The main outcomes included all-cause and CVD-specific mortality. Results A total of 19,951 US adults aged 30–79 years were included in this study. Only 19.5% of adults achieved a high total CVH score, whereas 24.1% had a low score. During a median follow-up of 7.6 years, compared with adults with a low total CVH score, those with an intermediate or high total CVH score had 40% (adjusted hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.51–0.71) and 58% (adjusted HR 0.42, 95% CI 0.32–0.56) reduced risk of all-cause mortality. The corresponding adjusted HRs (95%CIs) were 0.62 (0.46–0.83) and 0.36 (0.21–0.59) for CVD-specific mortality. The population-attributable fractions for high (score ≥ 75 points) vs. low or intermediate (score < 75 points) CVH scores were 33.4% for all-cause mortality and 42.9% for CVD-specific mortality. Among all 8 individual CVH metrics, physical activity, nicotine exposure, and diet accounted for a large proportion of the population-attributable risks for all-cause mortality, whereas physical activity, blood pressure, and blood glucose accounted for a large proportion of CVD-specific mortality. There were approximately linear dose–response associations of total CVH score (as a continuous variable) with all-cause and CVD-specific mortality. Conclusions Achieving a higher CVH score according to the new Life’s Essential 8 was associated with a reduced risk of all-cause and CVD-specific mortality. Public health and healthcare efforts targeting the promotion of higher CVH scores could provide considerable benefits to reduce the mortality burden later in life. |
| first_indexed | 2024-04-09T19:55:50Z |
| format | Article |
| id | doaj.art-ea11d9aa022b45518c653c95b42e18df |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-09T19:55:50Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-ea11d9aa022b45518c653c95b42e18df2023-04-03T05:30:02ZengBMCBMC Medicine1741-70152023-03-0121111310.1186/s12916-023-02824-8Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort studyJiahong Sun0Yanzhi Li1Min Zhao2Xiao Yu3Cheng Zhang4Costan G. Magnussen5Bo Xi6Department of Epidemiology/Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong UniversityKey Laboratory Experimental Teratology of the Ministry of Education, Department of Physiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong UniversityKey Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong UniversityBaker Heart and Diabetes InstituteDepartment of Epidemiology/Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong UniversityAbstract Background The American Heart Association recently updated its construct of what constitutes cardiovascular health (CVH), called Life’s Essential 8. We examined the association of total and individual CVH metrics according to Life’s Essential 8 with all-cause and cardiovascular disease (CVD)-specific mortality later in life. Methods Data were from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 at baseline linked to the 2019 National Death Index records. Total and individual CVH metric scores including diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure were classified as 0–49 (low level), 50–74 (intermediate level), and 75–100 (high level) points. The total CVH metric score (the average of the 8 metrics) as a continuous variable was also used for dose–response analysis. The main outcomes included all-cause and CVD-specific mortality. Results A total of 19,951 US adults aged 30–79 years were included in this study. Only 19.5% of adults achieved a high total CVH score, whereas 24.1% had a low score. During a median follow-up of 7.6 years, compared with adults with a low total CVH score, those with an intermediate or high total CVH score had 40% (adjusted hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.51–0.71) and 58% (adjusted HR 0.42, 95% CI 0.32–0.56) reduced risk of all-cause mortality. The corresponding adjusted HRs (95%CIs) were 0.62 (0.46–0.83) and 0.36 (0.21–0.59) for CVD-specific mortality. The population-attributable fractions for high (score ≥ 75 points) vs. low or intermediate (score < 75 points) CVH scores were 33.4% for all-cause mortality and 42.9% for CVD-specific mortality. Among all 8 individual CVH metrics, physical activity, nicotine exposure, and diet accounted for a large proportion of the population-attributable risks for all-cause mortality, whereas physical activity, blood pressure, and blood glucose accounted for a large proportion of CVD-specific mortality. There were approximately linear dose–response associations of total CVH score (as a continuous variable) with all-cause and CVD-specific mortality. Conclusions Achieving a higher CVH score according to the new Life’s Essential 8 was associated with a reduced risk of all-cause and CVD-specific mortality. Public health and healthcare efforts targeting the promotion of higher CVH scores could provide considerable benefits to reduce the mortality burden later in life.https://doi.org/10.1186/s12916-023-02824-8Cardiovascular healthLife’s Essential 8Cardiovascular diseaseMortalityProspective study |
| spellingShingle | Jiahong Sun Yanzhi Li Min Zhao Xiao Yu Cheng Zhang Costan G. Magnussen Bo Xi Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study BMC Medicine Cardiovascular health Life’s Essential 8 Cardiovascular disease Mortality Prospective study |
| title | Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study |
| title_full | Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study |
| title_fullStr | Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study |
| title_full_unstemmed | Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study |
| title_short | Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study |
| title_sort | association of the american heart association s new life s essential 8 with all cause and cardiovascular disease specific mortality prospective cohort study |
| topic | Cardiovascular health Life’s Essential 8 Cardiovascular disease Mortality Prospective study |
| url | https://doi.org/10.1186/s12916-023-02824-8 |
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