Wang Ziyuan, Barinas-Mitchell Emma, Brooks Maria M, Derby Carol A, Magnani Jared W, Thurston Rebecca C, Ylitalo Kelly R, Bertolet Marnie, El Khoudary Samar R
Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA.
The Saul R. Korey Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
Menopause. 2025 Aug 1;32(8):758-768. doi: 10.1097/GME.0000000000002549.
We aimed to characterize cardiovascular health status as measured by Life's Essential 8 (LE8) in midlife women and to test the associations between baseline and change since baseline in LE8 with subclinical measures of vascular health, cardiovascular disease (CVD) events, and all-cause mortality.
Baseline and follow-up LE8 metrics (diet, physical activity, nicotine exposure, sleep, body mass index, lipids, glucose, and blood pressure) were calculated as total and component scores. Changes in LE8 were calculated as differences between follow-up and baseline scores. Subclinical measures of vascular health included carotid intima-media thickness, pulse wave velocity, and carotid plaque presence. CVD events (n = 213) included myocardial infarction, stroke, heart failure, and revascularization. Deaths (n = 161) were recorded from death certificates/family reports. Linear, logistic, and Cox proportional hazards regression models were used.
Among 2,924 midlife women (mean age: 46 ± 3 y), 21% consistently showed ideal total LE8 scores (≥80) across visits. Higher baseline and greater increases in total LE8 scores were associated with more favorable measures of all outcomes. Among the components, more favorable baseline/greater increases in glucose, blood pressure, and nicotine exposure scores were generally associated with lower risks for all outcomes. Sleep quality was associated with events; with more favorable baseline and/or greater increases in sleep score associated with lower risks of CVD events and/or mortality.
The prevalence of ideal total LE8 scores remained below 25% among midlife women. Glucose, blood pressure, and nicotine exposure are critical components of associated risks with lower LE8 scores. Midlife sleep quality may uniquely contribute to future event risk.
我们旨在描述中年女性通过生命基本八项（LE8）所衡量的心血管健康状况，并测试LE8的基线水平及其自基线以来的变化与血管健康亚临床指标、心血管疾病（CVD）事件和全因死亡率之间的关联。
计算基线和随访时LE8指标（饮食、身体活动、尼古丁暴露、睡眠、体重指数、血脂、血糖和血压）的总分及各分项得分。LE8的变化通过随访得分与基线得分的差值计算得出。血管健康的亚临床指标包括颈动脉内膜中层厚度、脉搏波速度和颈动脉斑块的存在情况。CVD事件（n = 213）包括心肌梗死、中风、心力衰竭和血运重建。死亡（n = 161）通过死亡证明/家属报告记录。使用线性、逻辑和Cox比例风险回归模型。
在2924名中年女性（平均年龄：46±3岁）中，21%在各次访视中始终显示出理想的LE8总分（≥80）。较高的基线总分和LE8总分的更大增幅与所有结局的更有利指标相关。在各分项中，血糖、血压和尼古丁暴露得分的更有利基线水平/更大增幅通常与所有结局的较低风险相关。睡眠质量与事件相关；更有利的基线水平和/或睡眠得分的更大增幅与较低的CVD事件和/或死亡率风险相关。
中年女性中理想的LE8总分患病率仍低于25%。血糖、血压和尼古丁暴露是LE8得分较低相关风险的关键组成部分。中年时期的睡眠质量可能对未来事件风险有独特影响。
