Association of quantified cardiovascular health with all-cause mortality in prediabetic patients

Abstract Aim: We aimed to explore the association between all-cause mortality and cardiovascular health (CVH) lifestyle interventions (as accurately quantified by Life's essential 8) in prediabetic patients and to observe the dose-response relationship of the potential association. Methods and Participants: The retrospective study included 5344 participants with prediabetes (mean age: 52.9 SD = 15.8 years; (51.6% of men)). The Life's essential 8 (LE8) score includes four health indicators and four health behaviors. We calculated Cox proportional hazard ratios (HRS) for all-cause mortality in subgroups of high CVH (>= 80), low CVH (< 50), and moderate CVH (50-79) based on the CVH quantification score of LE8, and explored the dose-response relationship of potential associations. We also performed separate analyses of the associations of all-cause mortality with each LE8 components and CVH health behaviors and indicators. Results: In the median follow-up period of 8.33 years, 658 deaths occurred. Compared with participants with high CVH, the covariate-adjusted HR(95%CI) for participants with moderate and low CVH were 2.55(1.23-5.31) and 3.92 (1.70-9.02), respectively. There was a dose-response relationship between the improvement of CVH status and the reduction of all-cause mortality (P-overall < 0.0001, P-nonliner = 0.7989). The improvement of CVH health behaviors has a more significant protective effect on patients with prediabetes than CVH health indicators. Conclusion: High CVH status, quantified by LE8, has a significant effect on preventing mortality outcomes in prediabetic adults in the U.S.