Zhou Shi-Yu, Liu Fang-Chao, Chen Shu-Feng, Li Jian-Xin, Cao Jie, Huang Ke-Yong, Tang Zheng-Hao, Liang Feng-Chao, Hu Dong-Sheng, Zhao Lian-Cheng, Li Ying, Huang Jian-Feng, Lu Xiang-Feng, Lu Bin, Gu Dong-Feng
Department of Epidemiology & Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
School of Public Health and Emergency Management, School of Medicine, Southern University of Science and Technology, Shenzhen, China.
J Geriatr Cardiol. 2024 Jul 28;21(7):751-759. doi: 10.26599/1671-5411.2024.07.005.
Previous studies have demonstrated the benefits of ideal cardiovascular health (CVH) in reducing cardiovascular risk. However, its role in subclinical atherosclerosis (SA) progression remains unclear. We aim to examine the association of CVH, estimated by the American Heart Association's new Life's Essential 8 (LE8), with the progression of SA.
This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for 5.7 years. The LE8 score (range, 0-100) consisted of blood pressure, lipids, glucose, body mass index, smoking status, diet health, physical activity and sleep health was evaluated in 1998 and 2008-2009. Progression of SA was determined by carotid plaque and coronary artery calcification (CAC) in 2008-2009 and 2013-2014. Log-binomial regression model was used to estimate the association of LE8 score with SA progression.
Each 10 points increment in LE8 score was associated with 15.2% (RR: 0.848, 95% CI: 0.797-0.902), 17.7% (RR: 0.823, 95% CI: 0.766-0.884) and 12.0% (RR: 0.880, 95% CI: 0.845-0.916) lower risks of carotid plaque, CAC and overall SA progression, respectively. Compared with participants with non-ideal CVH at both visits, the participants with ideal CVH at both visits had 39.1% (RR: 0.609, 95% CI: 0.494-0.752), 41.0% (RR: 0.590, 95% CI: 0.456-0.764) and 29.7% (RR: 0.703, 95% CI: 0.598-0.825) lower risks of carotid plaque, CAC and overall SA progression, respectively.
Higher LE8 scores were associated with lower risks of SA progression. Besides, long-term maintenance of optimal CVH was more beneficial to prevent SA progression.
既往研究已证实理想心血管健康（CVH）在降低心血管风险方面的益处。然而，其在亚临床动脉粥样硬化（SA）进展中的作用仍不明确。我们旨在研究由美国心脏协会新提出的“生命八要素”（LE8）评估的CVH与SA进展之间的关联。
这项前瞻性队列研究在972名无症状中国参与者中进行，随访5.7年。LE8评分（范围0 - 100）由血压、血脂、血糖、体重指数、吸烟状况、饮食健康、身体活动和睡眠健康组成，于1998年以及2008 - 2009年进行评估。SA的进展通过2008 - 2009年以及2013 - 2014年的颈动脉斑块和冠状动脉钙化（CAC）来确定。采用对数二项回归模型来估计LE8评分与SA进展之间的关联。
LE8评分每增加10分，颈动脉斑块、CAC和总体SA进展风险分别降低15.2%（风险比：0.848，95%置信区间：0.797 - 0.902）、17.7%（风险比：0.823，95%置信区间：0.766 - 0.884）和12.0%（风险比：0.880，95%置信区间：0.845 - 0.916）。与两次访视时CVH均不理想的参与者相比，两次访视时CVH均理想的参与者颈动脉斑块、CAC和总体SA进展风险分别降低39.1%（风险比：0.609，95%置信区间：0.494 - 0.752）、41.0%（风险比：0.590，95%置信区间：0.456 - 0.764）和29.7%（风险比：0.703，95%置信区间：0.598 - 0.825）。
较高的LE8评分与较低的SA进展风险相关。此外，长期维持最佳CVH对预防SA进展更有益。
