基于“生命必需的 8 项指标”的西班牙心血管健康状况及其与全因和心血管死亡率的关系：ENRICA 队列研究。

Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort.

机构信息

Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.

Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2024 May;77(5):372-380. doi: 10.1016/j.rec.2023.09.001. Epub 2023 Sep 30.

DOI:10.1016/j.rec.2023.09.001

PMID:37783370

Abstract

INTRODUCTION AND OBJECTIVES

The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death.

METHODS

We used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression.

RESULTS

In total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8 ≤ 49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89).

CONCLUSIONS

A substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality.

摘要

简介和目的

美国心脏协会最近制定了“生命的基本 8 项”（LE8）评分，以鼓励预防心血管疾病（CVD）。本研究评估了 LE8 在西班牙成年人群中的分布情况及其与全因和 CVD 死亡的关系。

方法

我们使用了 2008 年至 2010 年间招募并随访至 2020 年至 2022 年的 ENRICA 研究中 11616 名年龄在 18 岁及以上（50.5%为女性）的个体的数据。LE8 评分包括 8 项指标（饮食、身体活动、尼古丁暴露、睡眠健康、体重指数、血脂和血糖以及血压），范围为 0 至 100。使用 Cox 回归总结 LE8 评分与死亡率之间的关联，用风险比（HR）表示。

结果

共有 13.2%的参与者（各地区范围为 6.1%-16.9%）心血管健康状况较差（LE8≤49）。在中位随访 12.9 年期间，共发生 908 例全因死亡，中位随访 11.8 年期间，确定了 207 例 CVD 死亡。在调整主要潜在混杂因素后，与处于 LE8 最不健康（最低）四分位数的参与者相比，第二、三、四分位数的全因死亡率 HR（95%CI）分别为 0.68（0.56-0.83）、0.63（0.51-0.78）和 0.53（0.39-0.72）。在考虑竞争死亡风险后，CVD 死亡率的相应数值分别为 0.62（0.39-0.97）、0.55（0.32-0.93）和 0.38（0.16-0.89）。