Gao Z, Qiu W, Xiong C, Zeng K, Li L
Concord Medical Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
J Postgrad Med. 2025 Jan 1;71(1):20-27. doi: 10.4103/jpgm.jpgm_776_24. Epub 2025 Mar 19.
Whether the protective role of optimal cardiovascular health (CVH) exists among individuals with preexisting cardiometabolic comorbidities and to what extent these impacts on longevity are unknown. This study aims to evaluate the protective effect on mortality in individuals with and without cardiometabolic comorbidities.
This cohort study utilized data from the China Health and Nutrition Survey. CVH was evaluated using the Life's Essential 8 (LE8) metric. Five cardiometabolic comorbidities, namely hypertension, diabetes mellitus (DM), dyslipidemia, chronic kidney disease (CKD), and cardiovascular disease (CVD), were self-reported. The outcome was all-cause mortality.
Maintaining intermediate/ideal CVH attenuated the hazardous impact of hypertension (intermediate/ideal CVH: HR: 1.02; 95% CI: 0.71, 1.47; poor CVH: HR: 1.50; 95% CI: 1.16, 1.95), prediabetes (intermediate/ideal CVH: HR: 1.00; 95% CI: 0.64, 1.55; poor CVH: HR: 1.81; 95% CI: 1.30, 2.52), DM (intermediate/ideal CVH: HR: 2.53; 95% CI: 1.65, 3.87; poor CVH: HR: 5.02; 95% CI: 3.74, 6.76), dyslipidemia (intermediate/ideal CVH: HR: 1.13; 95% CI: 0.76, 1.68; poor CVH: HR: 1.29; 95% CI: 0.89, 1.86), and CKD (intermediate/ideal CVH: HR: 1.36; 95% CI: 1.01, 1.84; poor CVH: HR: 1.84; 95% CI: 1.21, 2.79) on longevity ( P for interaction < 0.05). No significant interaction between CVD and CVH was observed in the association with mortality. CVH status significantly interacted with the associations between cardiometabolic comorbidities and the risk of mortality when the number of comorbidities increased up to 3.
CVH significantly attenuated the detrimental impacts of cardiometabolic comorbidities on longevity, highlighting the protective role of CVH even in individuals with preexisting cardiometabolic diseases.
在已患有心脏代谢合并症的个体中，最佳心血管健康（CVH）的保护作用是否存在以及这些作用对寿命的影响程度尚不清楚。本研究旨在评估CVH对有和没有心脏代谢合并症个体死亡率的保护作用。
本队列研究使用了中国健康与营养调查的数据。使用生命基本八大要素（LE8）指标评估CVH。通过自我报告获取五种心脏代谢合并症，即高血压、糖尿病（DM）、血脂异常、慢性肾脏病（CKD）和心血管疾病（CVD）。结局指标为全因死亡率。
维持中等/理想的CVH可减轻高血压（中等/理想CVH：风险比[HR]：1.02；95%置信区间[CI]：0.71，1.47；差的CVH：HR：1.50；95%CI：1.16，1.95）、糖尿病前期（中等/理想CVH：HR：1.00；95%CI：0.64，1.55；差的CVH：HR：1.81；95%CI：1.30，2.52）、DM（中等/理想CVH：HR：2.53；95%CI：1.65，3.87；差的CVH：HR：5.02；95%CI：3.74，6.76）、血脂异常（中等/理想CVH：HR：1.13；95%CI：0.76，1.68；差的CVH：HR：1.29；95%CI：0.89，1.86）和CKD（中等/理想CVH：HR：1.36；95%CI：1.01，1.84；差的CVH：HR：1.84；95%CI：1.21，2.79）对寿命的有害影响（交互作用P<0.05）。在与死亡率的关联中，未观察到CVD与CVH之间存在显著交互作用。当合并症数量增加至3种时，CVH状态与心脏代谢合并症和死亡风险之间的关联存在显著交互作用。
CVH显著减轻了心脏代谢合并症对寿命的有害影响，突出了CVH即使在已患有心脏代谢疾病的个体中的保护作用。
