Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd, Tangshan 063000, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Eur J Prev Cardiol. 2023 May 9;30(7):593-600. doi: 10.1093/eurjpc/zwad033.
Whereas cardiovascular disease (CVD) metrics define risk in individuals aged over 40 years, the earliest lesions of CVD appear well before this age. Cardiovascular health (CVH) was proposed to improve cardiovascular risk factors and was updated recently. This study aimed to explore the associations of baseline and long-term CVH assessed by 'Life's Essential 8' metrics with premature CVD and all-cause mortality in young Chinese adults.
A total of 16 011 CVD-free participants aged 18-40 years were enrolled from the Kailuan cohort study. The CVH score ranged from 0 to 100 and was categorized into low, moderate, and high. Cox regressions were used to assess the hazard ratios (HRs) for the associations of baseline, time-updated mean, and time-varying CVH with the risk of outcomes. During a median follow-up of 13 years, we identified 271 cases (1.7%) of CVD and 219 cases (1.4%) of all-cause mortality. A lower CVH was associated with a higher risk of CVD and all-cause mortality; the adjusted HR in the low CVH vs. the high CVH group was 7.34 [95% confidence interval (CI), 3.19-16.89] and 2.54 (95% CI, 1.27-5.06) for baseline CVH, 4.38 (95% CI, 2.14-8.97) and 1.99 (95% CI, 1.06-3.71) for time-updated CVH, and 8.19 (95% CI, 2.70-24.88) and 4.28 (95% CI, 1.70-10.81) for time-varying CVH, respectively.
We observed an inverse gradient association of baseline and long-term CVH with the risk of premature CVD and all-cause mortality in young adults, emphasizing the importance of keeping health behaviours and factors earlier in life.
This longitudinal prospective cohort study showed an inverse gradient association of baseline and long-term cardiovascular health, as measured by the new updated Life's Essential 8 metrics, with the risk of premature cardiovascular disease and all-cause mortality in Chinese young adults, emphasizing the importance of keeping health behaviours and factors earlier in life.Baseline and longitudinal low cardiovascular health (CVH) status (measured by time-updated mean and time-varying CVH score) was associated with a higher risk of cardiovascular disease (CVD) and all-cause mortality in young adults aged <40 years.Among the eight metrics of LE8, lower scores of health factors were associated with a higher risk of CVD and all-cause mortality in young adults, while the associations of health behaviours with CVD and all-cause mortality were non-significant.
心血管疾病 (CVD) 指标定义了 40 岁以上人群的风险，但 CVD 的最早病变早在这个年龄之前就出现了。心血管健康 (CVH) 的提出是为了改善心血管危险因素，并于近期进行了更新。本研究旨在探讨通过“生命必需的 8 项指标”评估的基线和长期 CVH 与年轻中国成年人的早发性 CVD 和全因死亡率之间的关系。
本研究共纳入了 16011 名年龄在 18-40 岁之间、无 CVD 的参与者，他们来自开滦队列研究。CVH 评分范围为 0 至 100，分为低、中、高三个等级。使用 Cox 回归评估基线、时间更新均值和时间变化的 CVH 与结局风险之间的关联的风险比 (HR)。在中位随访 13 年期间，我们发现了 271 例 (1.7%) CVD 和 219 例 (1.4%) 全因死亡。较低的 CVH 与 CVD 和全因死亡率的风险增加相关；与高 CVH 组相比，低 CVH 组的调整后 HR 分别为 7.34 [95%置信区间 (CI)，3.19-16.89] 和 2.54 (95% CI，1.27-5.06)，用于基线 CVH，4.38 (95% CI，2.14-8.97) 和 1.99 (95% CI，1.06-3.71) 用于时间更新的 CVH，以及 8.19 (95% CI，2.70-24.88) 和 4.28 (95% CI，1.70-10.81) 用于时间变化的 CVH。
我们观察到基线和长期 CVH 与年轻成年人早发性 CVD 和全因死亡率的风险呈负梯度关联，这强调了在生命早期保持健康行为和因素的重要性。
这项纵向前瞻性队列研究表明，根据新的更新后的“生命必需的 8 项指标”测量的基线和长期心血管健康状况与中国年轻成年人早发性心血管疾病和全因死亡率的风险呈负梯度关联，这强调了在生命早期保持健康行为和因素的重要性。在年龄<40 岁的年轻人中，较低的 CVH 状态（通过时间更新的平均和时间变化的 CVH 评分衡量）与 CVD 和全因死亡率的风险增加相关。在 LE8 的八项指标中，较低的健康因素评分与年轻人 CVD 和全因死亡率的风险增加相关，而健康行为与 CVD 和全因死亡率的关联则不显著。
