The impact of cardiovascular health on mortality in US adults with cardiometabolic disease: A prospective nationwide cohort study

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases Pub Date : 2025-02-01 DOI:10.1016/j.numecd.2024.08.011

Feifei Zhang , Huiliang Liu , Yuetao Xie , Litian Liu , Ohua Feng , Yingxiao Li

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引用次数: 0

Abstract

Background and aims

Individuals with cardiometabolic disease (CMD) face high risks of adverse outcomes. However, there is little evidence of the effectiveness of comprehensive risk assessment using the Life's Essential 8 (LE8) score in CMD. This study aimed to examine the associations between LE8 and all-cause and cardiovascular mortality rates in individuals with CMD.

Methods and results

This study included 11,198 NHANES participants, categorized into low, moderate, and high CVH groups according to LE8 scores. The LE8 score consists of eight components: diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure. A higher LE8 score indicates better cardiovascular health. Multivariable Cox proportional hazard regression and restricted cubic splines were employed to estimate the associations. Subgroup analyses considered age, sex, race and ethnicity, income, marital status, and education.

During a median follow-up of 91 months, 1079 deaths were recorded, 325 of which were cardiovascular. The multivariable adjusted hazard ratio (HR) per 10-point increase in LE8 was 0.79 (95% confidence interval (CI), 0.75–0.84) for all-cause mortality and 0.71 (95% CI, 0.64–0.79) for cardiovascular mortality. Participants with moderate and high LE8 levels showed similar inverse associations. Those under 60 exhibited more pronounced associations (P for interaction <0.05). After adjusting for multiple variables, a linear relationship was observed between LE8 and all-cause and cardiovascular mortality in the CMD population.

Conclusions

The newly introduced LE8 showed a significant negative association with all-cause and cardiovascular mortality risk among CMD individuals, highlighting its potential for CMD tertiary prevention.

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心血管健康对美国成人心血管代谢疾病患者死亡率的影响：一项前瞻性全国队列研究

患有心脏代谢疾病（CMD）的人面临着不良后果的高风险。然而，几乎没有证据表明使用生命必备 8（LE8）评分进行综合风险评估对 CMD 患者的有效性。本研究旨在研究 CMD 患者的 LE8 分值与全因死亡率和心血管死亡率之间的关系。这项研究包括 11,198 名 NHANES 参与者，根据 LE8 分数将他们分为低、中和高 CVH 组。LE8 分数由八个部分组成：饮食、体力活动、尼古丁暴露、睡眠健康、体重指数、血脂、血糖和血压。LE8 分数越高，表明心血管健康状况越好。采用多变量考克斯比例危险回归和限制性立方样条来估计相关性。分组分析考虑了年龄、性别、种族和民族、收入、婚姻状况和教育程度。新引入的 LE8 与 CMD 患者的全因和心血管死亡风险呈显著负相关，突出了其在 CMD 三级预防中的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition Metabolism and Cardiovascular Diseases 医学-内分泌学与代谢

CiteScore

6.80

自引率

2.60%

发文量

332

审稿时长

57 days

期刊介绍： Nutrition, Metabolism & Cardiovascular Diseases is a forum designed to focus on the powerful interplay between nutritional and metabolic alterations, and cardiovascular disorders. It aims to be a highly qualified tool to help refine strategies against the nutrition-related epidemics of metabolic and cardiovascular diseases. By presenting original clinical and experimental findings, it introduces readers and authors into a rapidly developing area of clinical and preventive medicine, including also vascular biology. Of particular concern are the origins, the mechanisms and the means to prevent and control diabetes, atherosclerosis, hypertension, and other nutrition-related diseases.