美国成年人生命基本八项与全因死亡率和心血管死亡率的关联：一项基于2005 - 2014年美国国家健康与营养检查调查的前瞻性队列研究。

Association of Life's Essential 8 with all-cause and cardiovascular mortality among US adults: A prospective cohort study from the NHANES 2005-2014.

作者信息

Yi Jiayi, Wang Lili, Guo Xinli, Ren Xiangpeng

机构信息

Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.

Department of Biochemistry, Medical College, Jiaxing University, Jiaxing, China.

出版信息

Nutr Metab Cardiovasc Dis. 2023 Jun;33(6):1134-1143. doi: 10.1016/j.numecd.2023.01.021. Epub 2023 Jan 28.

DOI:10.1016/j.numecd.2023.01.021

PMID:36775706

Abstract

BACKGROUND AND AIMS

This study aims to investigate the association of Life's Essential 8 (LE8), the recently updated algorithm for quantifying cardiovascular health (CVH) by the American Heart Association (AHA), with long-term outcomes among US adults.

METHODS AND RESULTS

This population-based prospective cohort study analyzed data of 23,110 participants aged 20 years or older from the National Health and Nutrition Examination Survey from 2005 to 2014 and their linked mortality data through December 2019. LE8 score (range 0-100) was measured according to AHA definitions and was categorized into low (0-49), moderate (50-79), and high (80-100) CVH. The weighted mean age of the study population was 47.0 years (95% confidence interval [CI], 46.4-47.5 years), and 11,840 were female (weighted percentage, 51.5%; 95% CI, 50.9-52.1%). During a median follow-up period of 113 months (up to 180 months), 2942 all-cause deaths occurred, including 738 CVD deaths. The LE8 score was significantly and inversely related to mortality from all causes (adjusted hazard ratio [HR] for per 10-score increase in LE8 score, 0.86; 95% CI, 0.82-0.90) and cardiovascular disease (adjusted HR for per 10-score increase in LE8 score, 0.81; 95% CI, 0.75-0.87). Compared with participants having low CVH, those having high CVH had a reduction of 40% (adjusted HR, 0.60; 95% CI, 0.48-0.75) in the risk for all-cause mortality and 54% (adjusted HR, 0.46; 95% CI, 0.31-0.68) in the risk for cardiovascular mortality.

CONCLUSIONS

Higher LE8 score was independently associated with lower risks of all-cause and cardiovascular mortality among US adults.

摘要

背景与目的

本研究旨在调查美国心脏协会（AHA）最近更新的用于量化心血管健康（CVH）的生命基本八项（LE8）与美国成年人长期预后之间的关联。

方法与结果

这项基于人群的前瞻性队列研究分析了2005年至2014年美国国家健康与营养检查调查中23110名20岁及以上参与者的数据，以及截至2019年12月他们的关联死亡数据。根据AHA的定义测量LE8评分（范围为0 - 100），并将其分为低（0 - 49）、中（50 - 79）和高（80 - 100）心血管健康类别。研究人群的加权平均年龄为47.0岁（95%置信区间[CI]，46.4 - 47.5岁），女性有11840人（加权百分比，51.5%；95%CI，50.9 - 52.1%）。在中位随访期113个月（最长180个月）内，发生了2942例全因死亡，其中包括738例心血管疾病死亡。LE8评分与全因死亡率显著负相关（LE8评分每增加10分的调整后风险比[HR]为0.86；95%CI，0.82 - 0.90），与心血管疾病死亡率也显著负相关（LE8评分每增加10分的调整后HR为0.81；95%CI，0.75 - 0.87）。与心血管健康水平低的参与者相比，心血管健康水平高的参与者全因死亡风险降低了40%（调整后HR，0.60；95%CI，0.48 - 0.75），心血管死亡风险降低了54%（调整后HR，0.46；95%CI，0.31 - 0.68）。