慢性肾脏病成人中生命必需的八项指标与心血管疾病发病风险及死亡率的关联

Association of Life's Essential 8 with risk of incident cardiovascular disease and mortality among adults with chronic kidney disease.

作者信息

Huo Zhenyu, Li Jinfeng, Zhang Shunming, Li Liuxin, Zhang Jingdi, Xu Yiran, Wang Aitian, Chen Shuohua, Feng Jun, Chen Zhangling, Wu Shouling, Geng Tingting, Huang Zhe, Gao Jingli

机构信息

School of Public Health, North China University of Science and Technology, Tangshan, PR China.

Department of Cardiology, Kailuan General Hospital, Tangshan, PR China.

出版信息

Am J Prev Cardiol. 2025 Apr 12;22:100994. doi: 10.1016/j.ajpc.2025.100994. eCollection 2025 Jun.

DOI:10.1016/j.ajpc.2025.100994

PMID:40290416

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12033946/

Abstract

BACKGROUND

The American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH), Life's Essential 8 (LE8). However, few studies have examined the association of LE8 with risk of cardiovascular disease (CVD) and mortality among individuals with chronic kidney disease (CKD). We investigated whether LE8 was associated with subsequent risk of CVD and mortality in the Chinese population of adults with CKD.

METHODS

This prospective study included 18,716 adults (55.4 ± 14.0 years, 77.9 % men) with CKD free of CVD at baseline from the Kailuan study. A LE8 score (range 0-100 points) was constructed based on diet, physical activity, smoking, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure. Incident CVD and mortality were identified by electronic health records and registers. Multivariable Cox regression models were used to compute hazard ratios (HRs) and 95 % confidence intervals (CIs).

RESULTS

During a median follow-up of 14.0 and 14.4 years, 2117 cases of CVD and 4190 deaths were documented. After adjusting for potential confounders, comparing the high LE8 score (80-100 points) to the low LE8 score (<50 points), the multivariable HRs (95 % CIs) were 0.28 (0.20, 0.40) for CVD, 0.14 (0.06, 0.34) for myocardial infarction, 0.35 (0.25, 0.50) for total stroke, and 0.68 (0.56, 0.83) for all-cause mortality, respectively.

CONCLUSIONS

Among patients with CKD, greater adherence to CVH, as defined by LE8, was significantly associated with a lower risk of CVD and all-cause mortality.

摘要

背景

美国心脏协会最近发布了一种用于评估心血管健康（CVH）的更新算法，即生命八大要素（LE8）。然而，很少有研究探讨LE8与慢性肾脏病（CKD）患者心血管疾病（CVD）风险及死亡率之间的关联。我们调查了在中国成年CKD患者中，LE8是否与CVD及死亡的后续风险相关。

方法

这项前瞻性研究纳入了开滦研究中18716名基线时无CVD的成年CKD患者（年龄55.4±14.0岁，男性占77.9%）。基于饮食、身体活动、吸烟、睡眠时间、体重指数、血脂、血糖和血压构建了LE8评分（范围为0 - 100分）。通过电子健康记录和登记册确定CVD事件和死亡情况。使用多变量Cox回归模型计算风险比（HRs）和95%置信区间（CIs）。

结果

在中位随访14.0年和14.4年期间，记录了2117例CVD病例和4190例死亡。在调整潜在混杂因素后，将高LE8评分（80 - 100分）与低LE8评分（<50分）进行比较，CVD的多变量HR（95%CI）为0.28（0.20，0.40），心肌梗死为0.14（0.06，0.34），总卒中为0.35（0.25，0.50），全因死亡率为0.68（0.56，0.83）。