van Loon Inge G, van der Schouw Yvonne T, Handoko M Louis, Verschuren W M Monique, Uijl Alicia
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
JACC Adv. 2025 Sep 12;4(10 Pt 2):102127. doi: 10.1016/j.jacadv.2025.102127.
Better cardiovascular health (CVH) lowers risk of heart failure (HF). CVH can be quantified using Life's Essential 8 (LE8), a score consisting of 8 health factors and behaviors.
The authors assessed the association between LE8 and risk for HF, and compared LE8 with its predecessor, Life's Simple 7 (LS7).
We included 37,803 participants from the EPIC-NL (European Prospective Investigation into Cancer and Nutrition-Netherlands) cohort. The LE8 score ranged from 0 to 100 and was categorized into low (0-49), moderate (50-79), and high (80-100) CVH. CVH classification was compared between LS7 and LE8 scoring. Adjusted Cox proportional hazard models were used to assess LE8 score with risk of HF, and CVH reclassification from LS7 to LE8.
Participants were predominantly female (74%), with a median age of 52 years (Q1-Q3: 42-58). Compared to low CVH (4%), those with high CVH (21%) had an 82% lower risk of developing HF (HR: 0.18; 95% CI: 0.12-0.26). CVH classification differed substantially between LE8 and LS7, with 75% vs 36% having moderate CVH, respectively, which could be attributed to an upward shift (90%) of participants from LS7 low CVH to LE8 moderate CVH. A graded, nonlinear association with risk for HF was observed for LE8, especially for moderate CVH scores.
LS7 and LE8 differ in scoring and CVH classification. While a strong inverse association exists between LE8 score classification and HF risk, the association is graded over the whole LE8 range, suggesting that nuances may be overlooked when using the proposed CVH classification for exploring HF risk.
更好的心血管健康（CVH）可降低心力衰竭（HF）风险。CVH可使用生命必需的8项指标（LE8）进行量化，该评分由8项健康因素和行为组成。
作者评估了LE8与HF风险之间的关联，并将LE8与其前身生命简单7项指标（LS7）进行比较。
我们纳入了来自EPIC-NL（欧洲癌症与营养前瞻性调查-荷兰）队列的37803名参与者。LE8评分范围为0至100，并分为低（0-49）、中（50-79）和高（80-100）CVH。比较了LS7和LE8评分的CVH分类。使用调整后的Cox比例风险模型评估LE8评分与HF风险以及从LS7到LE8的CVH重新分类情况。
参与者主要为女性（74%），中位年龄为52岁（第一四分位数-第三四分位数：42-58岁）。与低CVH（4%）相比，高CVH（21%）者发生HF的风险降低82%（风险比：0.18；95%置信区间：0.12-0.26）。LE8和LS7的CVH分类存在显著差异，分别有75%和36%的人具有中度CVH，这可归因于参与者从LS7低CVH向上转移至LE8中度CVH（90%）。观察到LE8与HF风险存在分级的非线性关联，尤其是对于中度CVH评分。
LS7和LE8在评分和CVH分类方面存在差异。虽然LE8评分分类与HF风险之间存在强烈的负相关，但这种关联在整个LE8范围内是分级的，这表明在使用提议的CVH分类探索HF风险时，细微差别可能被忽视。
