Guo James W, Ning Hongyan, Lloyd-Jones Donald M
Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA.
J Am Heart Assoc. 2025 Jan 7;14(1):e034388. doi: 10.1161/JAHA.124.034388. Epub 2024 Dec 24.
Cardiovascular health (CVH) assessment may have important benefits for adults with chronic diseases to prevent incident cardiovascular disease and additional chronic conditions. Few studies have compared CVH in adults with chronic diseases and healthy adults without chronic disease using the American Heart Association's (AHA's) Life's Essential 8 (LE8) metrics.
We used National Health and Nutrition Examination Survey data from 2013 to 2018 to identify the presence of 16 chronic diseases by participant self-report of diagnosis. We included adults aged 20 to 79 years. CVH was defined by AHA's LE8 metrics. Overall mean LE8 (range 0-100, higher = better CVH) and individual LE8 metric scores were calculated according to disease status for all participants and stratified by self-identified sex, race, and ethnicity. There were 12 296 adults (51% women; mean age, 46 years) representing >186 million noninstitutionalized US adults. Significantly, and often substantially, lower CVH scores were noted for adults with chronic disease (14 of 16 diseases studied) versus unaffected adults, including all subtypes of cardiovascular disease, lung diseases, chronic kidney disease, liver conditions, cancer, arthritis, cognitive decline, and depression. For example, mean overall LE8 score was 14.0 points lower in those with versus without chronic obstructive pulmonary disease (51.0 versus 65.0, <0.0001). Men and Black adults consistently had lower LE8 scores.
CVH is significantly poorer in adults with many chronic diseases compared with unaffected adults. These data suggest the utility of the LE8 score to identify groups for targeted optimization of CVH to enhance primary and secondary prevention efforts for cardiovascular disease and potentially for concomitant chronic diseases of aging.
心血管健康（CVH）评估对于患有慢性疾病的成年人预防心血管疾病及其他慢性疾病可能具有重要益处。很少有研究使用美国心脏协会（AHA）的生命八大要素（LE8）指标，对患有慢性疾病的成年人与无慢性疾病的健康成年人的CVH进行比较。
我们使用了2013年至2018年的国家健康与营养检查调查数据，通过参与者自我报告的诊断来确定16种慢性疾病的存在情况。我们纳入了年龄在20至79岁之间的成年人。CVH由AHA的LE8指标定义。根据所有参与者的疾病状况计算总体平均LE8（范围为0 - 100，分数越高表示CVH越好）和各个LE8指标得分，并按自我认定的性别、种族和族裔进行分层。共有12296名成年人（51%为女性；平均年龄46岁），代表了超过1.86亿非机构化的美国成年人。值得注意的是，患有慢性疾病的成年人（在所研究的16种疾病中有14种）的CVH得分显著低于未受影响的成年人，这些慢性疾病包括所有心血管疾病亚型、肺部疾病、慢性肾病、肝脏疾病、癌症、关节炎、认知衰退和抑郁症。例如，患有慢性阻塞性肺疾病的成年人与未患该病的成年人相比，总体平均LE8得分低14.0分（分别为51.0分和65.0分，P<0.0001）。男性和黑人成年人的LE8得分一直较低。
与未受影响的成年人相比，患有多种慢性疾病的成年人的CVH明显较差。这些数据表明LE8评分有助于识别需要针对性优化CVH的人群，以加强心血管疾病以及可能的伴随衰老慢性疾病的一级和二级预防工作。
