Cardiovascular Health, Genetic Susceptibility, and the Risk of Incident Autoimmune Disorders in the UK Biobank: A Prospective Cohort Study

May 15, 2025Journal of the American Heart Association

Heart Health and Genetic Risk Linked to New Autoimmune Disorders in UK Biobank Participants

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Abstract

Over 13.2 years, higher cardiovascular health levels were linked to a reduced risk of autoimmune disorders in 247,660 participants.

A total of 11,422 new autoimmune disorders were identified during the follow-up period.
Higher cardiovascular health, measured by Life's Essential 8 scores, was associated with a hazard ratio of 0.68 for overall autoimmune disorders.
Specific autoimmune conditions like Graves disease, inflammatory bowel disease, and rheumatoid arthritis showed similar associations with cardiovascular health.
A linear relationship was observed between continuous Life's Essential 8 scores and reduced risks of several autoimmune diseases.
Genetic predisposition significantly influenced these associations, with stronger protective effects noted in women and younger participants.

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BACKGROUND: Autoimmune diseases are closely linked to cardiovascular diseases. This study aimed to assess the relationship between cardiovascular health (CVH) defined by Life's Essential 8 (LE8), genetic predisposition, and the risk of 19 autoimmune disorders.

METHODS AND RESULTS: A total of 247 660 participants without prior autoimmune diseases from the UK Biobank were included. CVH was assessed using LE8 scores, categorized into low, moderate, and high. Cox proportional hazards models estimated the association between CVH, genetic susceptibility, and autoimmune disorder risk. Over 13.2 years of follow-up, 11 422 incident autoimmune disorders occurred. Higher CVH levels were associated with reduced risks of overall autoimmune disorders (hazard ratio, 0.68 [95% CI, 0.62-0.74]) and specific conditions, including Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, and type 1 diabetes. Dose-response analyses revealed a linear negative relationship between continuous LE8 scores and the risks of Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, and type 1 diabetes (>0.05). Genetic predisposition to autoimmune disorders (including ankylosing spondylitis, celiac disease, Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, Sjögren syndrome, systemic lupus erythematosus, systemic sclerosis, and type 1 diabetes) significantly modified these associations (<0.05), with protective effects more pronounced in women, participants aged <65 years, and those with low genetic risk. P P nonlinear interaction

CONCLUSIONS: LE8 scores inversely and linearly predicted autoimmune disease incidence. Prioritizing CVH optimization through LE8 adherence may reduce the global autoimmune disease burden.

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Cardiovascular Health, Genetic Susceptibility, and the Risk of Incident Autoimmune Disorders in the UK Biobank: A Prospective Cohort Study

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