Li Wenjuan, Xing Aijun, Lamballais Sander, Xu Wenqi, Chen Shuohua, Zhou Shenghua, Wu Shouling, Chen Zhangling
The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China.
Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China.
Eur J Public Health. 2024 Aug 1;34(4):766-773. doi: 10.1093/eurpub/ckae063.
The American Heart Association recently released an updated algorithm for evaluating cardiovascular health-Life's Essential 8 (LE8). However, the associations between changes in LE8 score over time and risk of cardiovascular disease (CVD) remain unclear.
We investigated associations between 6-year changes (2006-12) in LE8 score and risk of subsequent CVD events (2012-20) among 53 363 Chinese men and women from the Kailuan Study, who were free from CVD in 2012. The LE8 score was calculated based on eight components: diet quality, physical activity, smoking status, sleep health, body mass index, blood lipids, blood glucose and blood pressure. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
We documented 4281 incident CVD cases during a median of 7.7 years of follow-up. Compared with participants whose LE8 scores remained stable in a 6-year period, those with the large increases of LE8 score over the 6-year period had a lower risk of CVD, heart disease and stroke in the subsequent 8 years [HRs and 95% CIs: 0.67 (0.64, 0.70) for CVD, 0.65 (0.61, 0.69) for heart disease, 0.71 (0.67, 0.76) for stroke, all Ptrend < 0.001]. Conversely, those with the large decreases of LE8 score had 47%, 51% and 41% higher risk for CVD, heart disease and stroke, respectively. These associations were consistent across the subgroups stratified by risk factors.
Improving LE8 score in a short- and moderate-term was associated with a lower CVD risk, whereas decreased LE8 score over time was associated with a higher risk.
美国心脏协会最近发布了一种用于评估心血管健康的更新算法——生命基本八项（LE8）。然而，LE8评分随时间的变化与心血管疾病（CVD）风险之间的关联仍不明确。
我们在开滦研究中对53363名中国男性和女性进行了调查，这些人在2012年时无心血管疾病，研究了2006年至2012年期间LE8评分的6年变化与随后（2012年至2020年）心血管疾病事件风险之间的关联。LE8评分基于八个组成部分计算得出：饮食质量、身体活动、吸烟状况、睡眠健康、体重指数、血脂、血糖和血压。使用多变量调整的Cox比例风险模型来估计风险比（HR）和95%置信区间（CI）。
在中位随访7.7年期间，我们记录了4281例心血管疾病病例。与在6年期间LE8评分保持稳定的参与者相比，那些在6年期间LE8评分大幅增加的参与者在随后8年中心血管疾病、心脏病和中风的风险较低[心血管疾病的HR和95%CI：0.67（0.64，0.70），心脏病的HR和95%CI：0.65（0.61，0.69），中风的HR和95%CI：0.71（0.67，0.76），所有Ptrend<0.001]。相反，那些LE8评分大幅下降的参与者患心血管疾病、心脏病和中风的风险分别高出47%、51%和41%。这些关联在按风险因素分层的亚组中是一致的。
短期和中期内提高LE8评分与较低的心血管疾病风险相关，而随着时间推移LE8评分降低则与较高风险相关。
