Minneapolis Heart Institute Foundation Minneapolis MN.
Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA.
J Am Heart Assoc. 2023 Dec 5;12(23):e030764. doi: 10.1161/JAHA.123.030764. Epub 2023 Nov 28.
The association of the American Heart Association's updated cardiovascular health score, the Life's Essential 8 (LE8), with cardiovascular disease (CVD) and death is not described in the FHS (Framingham Heart Study).
We evaluated Framingham Offspring participants at examinations 2 and 6 (n=2888 and 1667; and mean age, 44 and 57 years, respectively), free of CVD with information on LE8 components. Using age-sex-adjusted Cox models, we related LE8 and its change (examination 2 to examination 6) with CVD and death risk and compared associations with those of the Life's Simple 7 score. Mean LE8 score at examination 2 was 67 points (minimum, 26 points; maximum, 100 points). At both examinations, participants were reclassified to a different cardiovascular health status, depending on which method (LE8 versus Life's Simple 7) was used (60% of participants in ideal Life's Simple 7 status were in intermediate LE8 category). On follow-up after examination 2 (median, 30 and 33 years for CVD and death, respectively), we observed 966 CVD events, and 1195 participants died. Participants having LE8≥68 (sample median) were at lower CVD and death risk compared with those with LE8<68 (examination 2: CVD hazard ratio [HR], 0.47 [95% CI, 0.41-0.54]; death HR, 0.55 [95% CI, 0.49-0.62]; all <0.001). Participants maintaining low LE8 scores during life course were at highest CVD and death risk (CVD: HRs ranging from 1.8 to 2.3; <0.001; death HR, 1.45 [95% CI, 1.13-1.85]; =0.003 versus high-high group).
Further studies are warranted to elucidate whether the LE8 score is a better marker of CVD and death risk, compared with Life's Simple 7 score.
美国心脏协会更新的心血管健康评分（Life's Essential 8，LE8）与心血管疾病（CVD）和死亡的关联在弗雷明汉心脏研究（Framingham Heart Study）中并未描述。
我们评估了弗雷明汉后代参与者在检查 2 和 6 时的情况（n=2888 和 1667；平均年龄分别为 44 岁和 57 岁），且无 CVD 病史，并提供了 LE8 成分的信息。使用年龄性别调整的 Cox 模型，我们将 LE8 及其变化（检查 2 到检查 6）与 CVD 和死亡风险相关联，并比较了与 Life's Simple 7 评分的关联。检查 2 时的平均 LE8 评分为 67 分（最低 26 分，最高 100 分）。在两次检查中，根据使用的方法（LE8 与 Life's Simple 7），参与者被重新分类为不同的心血管健康状况（Life's Simple 7 状态理想的 60%的参与者属于 LE8 中等类别）。在检查 2 后的随访中（CVD 和死亡的中位数分别为 30 年和 33 年），我们观察到 966 例 CVD 事件和 1195 例死亡。与 LE8<68 的参与者相比，LE8≥68（样本中位数）的参与者 CVD 和死亡风险较低（检查 2：CVD 危险比 [HR]，0.47 [95% CI，0.41-0.54]；死亡 HR，0.55 [95% CI，0.49-0.62]；均<0.001）。在整个生命过程中保持低 LE8 评分的参与者 CVD 和死亡风险最高（CVD：HR 范围从 1.8 到 2.3；<0.001；死亡 HR，1.45 [95% CI，1.13-1.85]；=0.003 与高-高组相比）。
需要进一步的研究来阐明 LE8 评分与 Life's Simple 7 评分相比，是否是 CVD 和死亡风险的更好标志物。
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