Jha Mawra, Dong Zhiyong, Ruda Maria M, Prescott Brenton, Xanthakis Vanessa, Nayor Matthew, Gajjar Priya, Larson Martin G, Benjamin Emelia J, Vasan Ramachandran S, Mitchell Gary F, Tsao Connie W
Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA.
Department of Internal Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA.
Am J Prev Cardiol. 2025 Aug 23;23:101083. doi: 10.1016/j.ajpc.2025.101083. eCollection 2025 Sep.
In adults without cardiovascular disease (CVD), there is limited understanding of the association between overall cardiovascular health (CVH) and arterial health.
In 2330 Framingham Heart Study Offspring participants free of CVD (60±9 years; 57% women) with Life's Essential 8 (LE8) and applanation tonometry data (Exam 7), we calculated CVH scores per American Heart Association's LE8 guidelines. Multivariable-adjusted regression analyses examined the relations of LE8 with aortic stiffness and pressure pulsatility [negative inverse carotid-femoral pulse wave velocity (niCFPWV), central pulse pressure (CPP), respectively], and examined effect modification by age and sex. We also evaluated niCFPWV and CPP as mediators of the relation between LE8 and death outcomes (CVD, all-cause mortality).
Higher LE8 scores (better CVH) were associated with lower niCFPWV [standardized (std) β= -0.20±0.02, p<0.0001] and CPP (std β= -0.11±0.02, p<0.0001). While age- and sex- interactions were not significant, stratified analysis revealed stronger association of LE8 with arterial health in women (niCFPWV: std β= -0.11±0.02, p<0.0001 vs. std β= -0.06±0.03, p=0.04; CPP: std β= -0.13±0.03, p<0.001 vs. std β= -0.06±0.03, p=0.07 in women vs. men, respectively). niCFPWV and CPP mediated 19% and 10% of the association between LE8 and CVD mortality, respectively, and 17% and 15% of the association between LE8 and all-cause mortality, respectively.
Better CVH measured by LE8 was associated with lower arterial stiffness and pressure pulsatility, both of which mediate a significant proportion of the associations between CVH and CVD/death outcomes. These findings underscore the importance of optimal cardiovascular health behaviors and factors in maintaining arterial health.
在无心血管疾病（CVD）的成年人中，人们对整体心血管健康（CVH）与动脉健康之间的关联了解有限。
在2330名弗雷明汉心脏研究后代参与者中，这些人无CVD（年龄60±9岁；57%为女性），有生命要素8项（LE8）和压平眼压测量数据（第7次检查），我们根据美国心脏协会的LE8指南计算了CVH分数。多变量调整回归分析研究了LE8与主动脉僵硬度和压力搏动性的关系[分别为负向逆颈股脉搏波速度（niCFPWV）、中心脉压（CPP）]，并研究了年龄和性别的效应修正。我们还评估了niCFPWV和CPP作为LE8与死亡结局（CVD、全因死亡率）之间关系的中介因素。
较高的LE8分数（更好的CVH）与较低的niCFPWV（标准化（std）β = -0.20±0.02，p<0.0001）和CPP（std β = -0.11±0.02，p<0.0001）相关。虽然年龄和性别的交互作用不显著，但分层分析显示LE8与女性动脉健康的关联更强（niCFPWV：std β = -0.11±0.02，p<0.0001 vs. std β = -0.06±0.03，p = 0.04；CPP：std β = -0.13±0.03，p<0.001 vs. std β = -0.06±0.03，p = 0.07，女性与男性相比）。niCFPWV和CPP分别介导了LE8与CVD死亡率之间关联的19%和10%，以及LE8与全因死亡率之间关联的17%和15%。
通过LE8测量的更好的CVH与较低的动脉僵硬度和压力搏动性相关，这两者在CVH与CVD/死亡结局之间的关联中起很大比例的中介作用。这些发现强调了最佳心血管健康行为和因素在维持动脉健康中的重要性。
