生命的基本要素 8 、遗传易感性与心血管疾病发病：一项前瞻性研究。
Life's Essential 8, Genetic Susceptibility, and Incident Cardiovascular Disease: A Prospective Study.
机构信息
Department of Epidemiology, School of Public Health and Tropical Medicine (X.L., H.M., X.W., L.Q.), Tulane University, LA.
Tulane Research Innovation for Arrhythmias Discovery, School of Medicine (H.F.), Tulane University, LA.
出版信息
Arterioscler Thromb Vasc Biol. 2023 Jul;43(7):1324-1333. doi: 10.1161/ATVBAHA.123.319290. Epub 2023 May 18.
BACKGROUND
The American Heart Association recently released a new cardiovascular health (CVH) metric, Life's Essential 8 (LE8), for health promotion. However, the association between levels of LE8 and the risk of cardiovascular disease (CVD) outcomes is not known from a large prospective cohort. We aim to analyze the relationship between CVH, indicated by LE8, and risks of coronary heart disease (CHD), stroke, and CVD. Moreover, we sought to test whether the genetic susceptibility to CHD or stroke could be modified by LE8.
METHODS
A total of 137 794 participants free of CVD from the UK Biobank were included. CVH was scored using LE8 and categorized as low, moderate, and high.
RESULTS
During a median of 10 years, 8595 CVD cases (6968 CHDs and 1948 strokes) were documented. A higher LE8 score was associated with remarkably lower risks of CHD, stroke, and CVD (<0.001 for all). Comparing the high CVH to the low CVH, the hazard ratios (95% CI) were 0.34 (0.30-0.38) for CHD, 0.45 (0.37-0.54) for stroke, and 0.36 (0.33-0.40) for CVD. Moreover, the model with LE8 achieved higher accuracy and outperformed the model with Life's Simple 7 for CHD, stroke, and CVD (<0.001 for all). The protective associations of the LE8 score with CVD outcomes were more pronounced among women ( interaction, <0.001 for CHD and 0.0013 for CVD, respectively) and among younger adults ( interaction, <0.001, 0.007, and <0.001 for CHD, stroke, and CVD, respectively). In addition, a significant interaction was found between the genetic risk of CHD and the LE8 score ( interaction, <0.001). The inverse association was stronger among those with a lower genetic risk of CHD.
CONCLUSIONS
High level of CVH, defined by LE8, was associated with significantly lower risks of CHD, stroke, and CVD.
背景
美国心脏协会最近发布了一项新的心血管健康（CVH）指标——生命的八大要素（LE8），用于促进健康。然而，从大型前瞻性队列研究中尚不清楚 LE8 水平与心血管疾病（CVD）结局之间的关系。我们旨在分析 LE8 所示的 CVH 与冠心病（CHD）、中风和 CVD 风险之间的关系。此外，我们还试图检验 LE8 是否可以改变 CHD 或中风的遗传易感性。
方法
共纳入来自英国生物库的 137794 名无 CVD 的参与者。使用 LE8 对 CVH 进行评分，并分为低、中、高。
结果
在中位 10 年的随访期间，共记录到 8595 例 CVD 病例（6968 例 CHD 和 1948 例中风）。较高的 LE8 评分与 CHD、中风和 CVD 的风险显著降低显著相关（所有 P<0.001）。与低 CVH 相比，高 CVH 的危险比（95%CI）分别为 CHD 0.34（0.30-0.38）、中风 0.45（0.37-0.54）和 CVD 0.36（0.33-0.40）。此外，LE8 评分模型的准确性更高，并且在 CHD、中风和 CVD 方面均优于 Life's Simple 7 模型（所有 P<0.001）。在女性（交互作用，P<0.001，分别为 CHD 和 CVD）和年轻成年人（交互作用，P<0.001，0.007，分别为 CHD、中风和 CVD）中，LE8 评分与 CVD 结局的保护相关性更为显著。此外，还发现 CHD 的遗传风险与 LE8 评分之间存在显著的交互作用（交互作用，P<0.001）。在 CHD 遗传风险较低的人群中，这种负相关更为明显。
结论
由 LE8 定义的高水平 CVH 与 CHD、中风和 CVD 的风险显著降低相关。
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