Background Information regarding the association between cardiovascular health (CVH) as assessed using Life’s Essential 8 (LE8) approach and all-cause mortality in adults with early-onset cardiovascular diseases (CVDs) is limited. Objective In this study, we aimed to assess the association between CVH constructed by the LE8 metrics and all-cause mortality in Chinese individuals with early-onset CVDs, including myocardial infarction, heart failure, atrial fibrillation, ischemic stroke, and hemorrhagic stroke as well as in those who had undergone coronary artery bypass surgery or coronary intervention. Methods Data of 3454 participants who were first diagnosed with early-onset CVDs (men aged < 55 years and women aged < 65 years with CVDs) in the Kailuan study from 1 January 2006 to 31 December 2020 were analyzed. Assessment of CVH (score ranging from 0 to 100 points) was made using the LE8 metrics (including diet, physical activity, nicotine exposure, sleep duration, body mass index [BMI], lipid, blood glucose, and blood pressure). All-cause mortality information was collected from provincial vital statistics offices. Cox proportional hazard regression models and restricted cubic splines were utilized to examine associations between the CVH scores and all-cause mortality in adults with early-onset CVDs. Results During a mean follow-up of 6.78 years (interquartile range [IQR]: 3.36–10.5 years), 460 deaths were documented. After controlling for demographic variables, lifestyles, and major clinical factors, higher CVH scores were associated with lower risks of all-cause mortality among participants with early-onset CVDs. The corresponding hazard ratios (HRs) with 95% confidence intervals (CIs) were 0.64 (0.49, 0.82) comparing two extreme quartiles of CVH scores and 0.85 (0.77, 0.82) for each 10-point increment in CVH score (p trend = 0.001). Specifically, significant inverse associations were observed among participants with hemorrhagic stroke (HR Q4 vs. Q1 = 0.46, 0.23–0.93) and heart disease (HR Q4 vs. Q1 = 0.59, 0.41–0.87). Conclusion Our findings supported the beneficial role of higher CVH scores in all-cause mortality among adults with early-onset CVD.

Life’s Essential 8 and mortality among adults with early-onset cardiovascular diseases

期刊论文
发表日期：

2025年2月21日

查看全文

Jing Yang,
Xiao Chen,
Yaqi Li,
Shuohua Chen,
Xiang Gao,
Shouling Wu

摘要

Background

Information regarding the association between cardiovascular health (CVH) as assessed using Life’s Essential 8 (LE8) approach and all-cause mortality in adults with early-onset cardiovascular diseases (CVDs) is limited.

Objective

In this study, we aimed to assess the association between CVH constructed by the LE8 metrics and all-cause mortality in Chinese individuals with early-onset CVDs, including myocardial infarction, heart failure, atrial fibrillation, ischemic stroke, and hemorrhagic stroke as well as in those who had undergone coronary artery bypass surgery or coronary intervention.

Methods

Data of 3454 participants who were first diagnosed with early-onset CVDs (men aged < 55 years and women aged < 65 years with CVDs) in the Kailuan study from 1 January 2006 to 31 December 2020 were analyzed. Assessment of CVH (score ranging from 0 to 100 points) was made using the LE8 metrics (including diet, physical activity, nicotine exposure, sleep duration, body mass index [BMI], lipid, blood glucose, and blood pressure). All-cause mortality information was collected from provincial vital statistics offices. Cox proportional hazard regression models and restricted cubic splines were utilized to examine associations between the CVH scores and all-cause mortality in adults with early-onset CVDs.

Results

During a mean follow-up of 6.78 years (interquartile range [IQR]: 3.36–10.5 years), 460 deaths were documented. After controlling for demographic variables, lifestyles, and major clinical factors, higher CVH scores were associated with lower risks of all-cause mortality among participants with early-onset CVDs. The corresponding hazard ratios (HRs) with 95% confidence intervals (CIs) were 0.64 (0.49, 0.82) comparing two extreme quartiles of CVH scores and 0.85 (0.77, 0.82) for each 10-point increment in CVH score (p _trend = 0.001). Specifically, significant inverse associations were observed among participants with hemorrhagic stroke (HR _{Q4 vs. Q1} = 0.46, 0.23–0.93) and heart disease (HR _{Q4 vs. Q1} = 0.59, 0.41–0.87).

Conclusion

Our findings supported the beneficial role of higher CVH scores in all-cause mortality among adults with early-onset CVD.