The impact of cardiovascular health on mortality in US adults with cardiometabolic disease: A prospective nationwide cohort study

Sep 14, 2024Nutrition, metabolism, and cardiovascular diseases : NMCD

How heart and blood vessel health relates to death risk in US adults with metabolic and heart conditions

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Abstract

A 10-point increase in the Life's Essential 8 (LE8) score is associated with a 21% reduction in all-cause mortality risk.

Higher LE8 scores indicate better cardiovascular health.
Among 11,198 participants, 1,079 deaths were recorded during a median follow-up of 91 months.
The hazard ratio for all-cause mortality per 10-point increase in LE8 was 0.79, while it was 0.71 for cardiovascular mortality.
Moderate and high LE8 levels are linked to similar reductions in mortality risk.
Participants under 60 showed more pronounced associations between LE8 scores and mortality.
A linear relationship was observed between LE8 and mortality risk in the cardiometabolic disease population.

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BACKGROUND AND AIMS: Individuals with cardiometabolic disease (CMD) face high risks of adverse outcomes. However, there is little evidence of the effectiveness of comprehensive risk assessment using the Life's Essential 8 (LE8) score in CMD. This study aimed to examine the associations between LE8 and all-cause and cardiovascular mortality rates in individuals with CMD.

METHODS AND RESULTS: This study included 11,198 NHANES participants, categorized into low, moderate, and high CVH groups according to LE8 scores. The LE8 score consists of eight components: diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure. A higher LE8 score indicates better cardiovascular health. Multivariable Cox proportional hazard regression and restricted cubic splines were employed to estimate the associations. Subgroup analyses considered age, sex, race and ethnicity, income, marital status, and education. During a median follow-up of 91 months, 1079 deaths were recorded, 325 of which were cardiovascular. The multivariable adjusted hazard ratio (HR) per 10-point increase in LE8 was 0.79 (95% confidence interval (CI), 0.75-0.84) for all-cause mortality and 0.71 (95% CI, 0.64-0.79) for cardiovascular mortality. Participants with moderate and high LE8 levels showed similar inverse associations. Those under 60 exhibited more pronounced associations (P for interaction <0.05). After adjusting for multiple variables, a linear relationship was observed between LE8 and all-cause and cardiovascular mortality in the CMD population.

CONCLUSIONS: The newly introduced LE8 showed a significant negative association with all-cause and cardiovascular mortality risk among CMD individuals, highlighting its potential for CMD tertiary prevention.

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The impact of cardiovascular health on mortality in US adults with cardiometabolic disease: A prospective nationwide cohort study

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