{"title":"Life's Essential 8 and mortality among adults with early-onset cardiovascular diseases : A prospective community-based study.","authors":"Jing Yang, Xiao Chen, Yaqi Li, Shuohua Chen, Xiang Gao, Shouling Wu","doi":"10.1007/s00059-025-05293-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Information regarding the association between cardiovascular health (CVH) as assessed using Life's Essential 8 (LE8) approach and all-cause mortality in adults with early-onset cardiovascular diseases (CVDs) is limited.</p><p><strong>Objective: </strong>In this study, we aimed to assess the association between CVH constructed by the LE8 metrics and all-cause mortality in Chinese individuals with early-onset CVDs, including myocardial infarction, heart failure, atrial fibrillation, ischemic stroke, and hemorrhagic stroke as well as in those who had undergone coronary artery bypass surgery or coronary intervention.</p><p><strong>Methods: </strong>Data of 3454 participants who were first diagnosed with early-onset CVDs (men aged < 55 years and women aged < 65 years with CVDs) in the Kailuan study from 1 January 2006 to 31 December 2020 were analyzed. Assessment of CVH (score ranging from 0 to 100 points) was made using the LE8 metrics (including diet, physical activity, nicotine exposure, sleep duration, body mass index [BMI], lipid, blood glucose, and blood pressure). All-cause mortality information was collected from provincial vital statistics offices. Cox proportional hazard regression models and restricted cubic splines were utilized to examine associations between the CVH scores and all-cause mortality in adults with early-onset CVDs.</p><p><strong>Results: </strong>During a mean follow-up of 6.78 years (interquartile range [IQR]: 3.36-10.5 years), 460 deaths were documented. After controlling for demographic variables, lifestyles, and major clinical factors, higher CVH scores were associated with lower risks of all-cause mortality among participants with early-onset CVDs. The corresponding hazard ratios (HRs) with 95% confidence intervals (CIs) were 0.64 (0.49, 0.82) comparing two extreme quartiles of CVH scores and 0.85 (0.77, 0.82) for each 10-point increment in CVH score (p <sub>trend</sub> = 0.001). Specifically, significant inverse associations were observed among participants with hemorrhagic stroke (HR <sub>Q4 vs. Q1</sub> = 0.46, 0.23-0.93) and heart disease (HR <sub>Q4 vs. Q1</sub> = 0.59, 0.41-0.87).</p><p><strong>Conclusion: </strong>Our findings supported the beneficial role of higher CVH scores in all-cause mortality among adults with early-onset CVD.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Herz","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00059-025-05293-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Information regarding the association between cardiovascular health (CVH) as assessed using Life's Essential 8 (LE8) approach and all-cause mortality in adults with early-onset cardiovascular diseases (CVDs) is limited.
Objective: In this study, we aimed to assess the association between CVH constructed by the LE8 metrics and all-cause mortality in Chinese individuals with early-onset CVDs, including myocardial infarction, heart failure, atrial fibrillation, ischemic stroke, and hemorrhagic stroke as well as in those who had undergone coronary artery bypass surgery or coronary intervention.
Methods: Data of 3454 participants who were first diagnosed with early-onset CVDs (men aged < 55 years and women aged < 65 years with CVDs) in the Kailuan study from 1 January 2006 to 31 December 2020 were analyzed. Assessment of CVH (score ranging from 0 to 100 points) was made using the LE8 metrics (including diet, physical activity, nicotine exposure, sleep duration, body mass index [BMI], lipid, blood glucose, and blood pressure). All-cause mortality information was collected from provincial vital statistics offices. Cox proportional hazard regression models and restricted cubic splines were utilized to examine associations between the CVH scores and all-cause mortality in adults with early-onset CVDs.
Results: During a mean follow-up of 6.78 years (interquartile range [IQR]: 3.36-10.5 years), 460 deaths were documented. After controlling for demographic variables, lifestyles, and major clinical factors, higher CVH scores were associated with lower risks of all-cause mortality among participants with early-onset CVDs. The corresponding hazard ratios (HRs) with 95% confidence intervals (CIs) were 0.64 (0.49, 0.82) comparing two extreme quartiles of CVH scores and 0.85 (0.77, 0.82) for each 10-point increment in CVH score (p trend = 0.001). Specifically, significant inverse associations were observed among participants with hemorrhagic stroke (HR Q4 vs. Q1 = 0.46, 0.23-0.93) and heart disease (HR Q4 vs. Q1 = 0.59, 0.41-0.87).
Conclusion: Our findings supported the beneficial role of higher CVH scores in all-cause mortality among adults with early-onset CVD.
期刊介绍：
Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.
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