The protective role of cardiovascular health in the associations between cardiometabolic comorbidities and mortality: A national-wide cohort study.

Introduction: Whether the protective role of optimal cardiovascular health (CVH) exists among individuals with preexisting cardiometabolic comorbidities and to what extent these impacts on longevity are unknown. This study aims to evaluate the protective effect on mortality in individuals with and without cardiometabolic comorbidities.

Materials and methods: This cohort study utilized data from the China Health and Nutrition Survey. CVH was evaluated using the Life's Essential 8 (LE8) metric. Five cardiometabolic comorbidities, namely hypertension, diabetes mellitus (DM), dyslipidemia, chronic kidney disease (CKD), and cardiovascular disease (CVD), were self-reported. The outcome was all-cause mortality.

Results: Maintaining intermediate/ideal CVH attenuated the hazardous impact of hypertension (intermediate/ideal CVH: HR: 1.02; 95% CI: 0.71, 1.47; poor CVH: HR: 1.50; 95% CI: 1.16, 1.95), prediabetes (intermediate/ideal CVH: HR: 1.00; 95% CI: 0.64, 1.55; poor CVH: HR: 1.81; 95% CI: 1.30, 2.52), DM (intermediate/ideal CVH: HR: 2.53; 95% CI: 1.65, 3.87; poor CVH: HR: 5.02; 95% CI: 3.74, 6.76), dyslipidemia (intermediate/ideal CVH: HR: 1.13; 95% CI: 0.76, 1.68; poor CVH: HR: 1.29; 95% CI: 0.89, 1.86), and CKD (intermediate/ideal CVH: HR: 1.36; 95% CI: 1.01, 1.84; poor CVH: HR: 1.84; 95% CI: 1.21, 2.79) on longevity ( P for interaction < 0.05). No significant interaction between CVD and CVH was observed in the association with mortality. CVH status significantly interacted with the associations between cardiometabolic comorbidities and the risk of mortality when the number of comorbidities increased up to 3.

Conclusions: CVH significantly attenuated the detrimental impacts of cardiometabolic comorbidities on longevity, highlighting the protective role of CVH even in individuals with preexisting cardiometabolic diseases.