The association between life's essential 8 health behavior component score and all-cause and cardiovascular mortality among U.S. adults with cardiovascular-kidney-metabolic syndrome stages 0-3.

Objective: To investigate the association between Life's Essential 8 (LE8) health behavior component score and mortality outcomes among individuals with Cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3.

Methods: 8067 U.S. adults from the National Health and Nutrition Examination Survey 2005-2018, aged 30-79 years with CKM syndrome stages 0-3, were analyzed. Mortality status was obtained via linkage to the National Death Index through December 31, 2019. Kaplan-Meier analysis, multivariable Cox regression, and restricted cubic splines (RCS) were used to examine associations between LE8 health behavior component score and mortality outcomes.

Results: CKM stages were distributed as follows: 7.8 % (stage 0), 21.0 % (stage 1), 64.0 % (stage 2), and 7.3 % (stage 3). Higher LE8 total score and health behavior component score were linked to reduction in all-cause mortality and cardiovascular mortality risk. RCS analysis showed a linear relationship between LE8 total score, health behavior component score and mortality outcomes. Interaction between health behavior component score and CKM syndrome stages was identified for all-cause mortality.

Conclusions: Higher LE8 health behavior component score is associated with reduced all-cause and cardiovascular mortality among population with CKM syndrome stages 0-3. These findings support the potential value of behavior-targeted interventions tailored to CKM syndrome stages.