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Song C, Cheng X, Bai Y. Association of change in cardiovascular health based on life's essential 8 with incident cardiovascular disease. Am J Prev Cardiol 2024; 18:100668. [PMID: 38646020 PMCID: PMC11033071 DOI: 10.1016/j.ajpc.2024.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/13/2024] [Accepted: 04/04/2024] [Indexed: 04/23/2024] Open
Abstract
Objective To evaluate whether and to what extent changes in cardiovascular health (CVH) based on life's essential 8 (LE8) are associated with incident cardiovascular disease (CVD). Methods A total of 7,194 participants were derived from UK Biobank. CVH was evaluated using a modified version of LE8. Participants were classified into three groups according to their LE8 score: high CVH (LE8 score≥80), moderate CVH (50≤LE8 score<80), and low CVH (LE8 score<50). Changes in CVH between 2006/2010 and 2012/2013 were analyzed. Results During a median of 10.3 years of follow-up, CVD was observed in 597 participants. Compared to the consistent moderate group, the moderate to low group was associated with about 128 % increased risk of CVD (Hazard ratio [HR]: 2.28; 95 % confidence interval [CI]: 1.61, 3.23), and the relevant HR (95 % CI) was 2.19 (1.46, 3.29) for the consistent low group; no statistically significant results were observed in the other groups. Moreover, no statistically significant exposure-response association between absolute change in LE8 score and incident CVD was documented (Poverall=0.15). Conclusion Change in CVH based on LE8 was associated with the risk of CVD; however, the relationship varied widely in different CVH change patterns.
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Affiliation(s)
- Chao Song
- Nosocomial Infection Control Center, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
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Ravichandran S, Gajjar P, Walker ME, Prescott B, Tsao CW, Jha M, Rao P, Miller P, Larson MG, Vasan RS, Shah RV, Xanthakis V, Lewis GD, Nayor M. Life's Essential 8 Cardiovascular Health Score and Cardiorespiratory Fitness in the Community. J Am Heart Assoc 2024; 13:e032944. [PMID: 38700001 DOI: 10.1161/jaha.123.032944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/14/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND The relation of cardiorespiratory fitness (CRF) to lifestyle behaviors and factors linked with cardiovascular health remains unclear. We aimed to understand how the American Heart Association's Life's Essential 8 (LE8) score (and its changes over time) relate to CRF and complementary exercise measures in community-dwelling adults. METHODS AND RESULTS Framingham Heart Study (FHS) participants underwent maximum effort cardiopulmonary exercise testing for direct quantification of peak oxygen uptake (V̇O2). A 100-point LE8 score was constructed as the average across 8 factors: diet, physical activity, nicotine exposure, sleep, body mass index, lipids, blood glucose, and blood pressure. We related total LE8 score, score components, and change in LE8 score over 8 years with peak V̇O2 (log-transformed) and complementary CRF measures. In age- and sex-adjusted linear models (N=1838, age 54±9 years, 54% women, LE8 score 76±12), a higher LE8 score was associated favorably with peak V̇O2, ventilatory efficiency, resting heart rate, and blood pressure response to exercise (all P<0.0001). A clinically meaningful 5-point higher LE8 score was associated with a 6.0% greater peak V̇O2 (≈1.4 mL/kg per minute at sample mean). All LE8 components were significantly associated with peak V̇O2 in models adjusted for age and sex, but blood lipids, diet, and sleep health were no longer statistically significant after adjustment for all LE8 components. Over an ≈8-year interval, a 5-unit increase in LE8 score was associated with a 3.7% higher peak V̇O2 (P<0.0001). CONCLUSIONS Higher LE8 score and improvement in LE8 over time was associated with greater CRF, highlighting the importance of the LE8 factors in maintaining CRF.
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Affiliation(s)
| | - Priya Gajjar
- Section of Cardiovascular Medicine, Department of Medicine Boston University School of Medicine MA USA
| | - Maura E Walker
- Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA USA
- Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences Boston University Boston MA USA
| | - Brenton Prescott
- Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA USA
| | - Connie W Tsao
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center Harvard Medical School Boston MA USA
| | - Mawra Jha
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center Harvard Medical School Boston MA USA
| | - Prashant Rao
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center Harvard Medical School Boston MA USA
| | - Patricia Miller
- Department of Biostatistics Boston University School of Public Health Boston MA USA
| | - Martin G Larson
- Department of Biostatistics Boston University School of Public Health Boston MA USA
- Framingham Heart Study Framingham MA USA
| | - Ramachandran S Vasan
- Framingham Heart Study Framingham MA USA
- University of Texas School of Public Health San Antonio TX USA
- Departments of Medicine and Population Health Sciences University of Texas Health Science Center San Antonio TX USA
| | - Ravi V Shah
- Vanderbilt Translational and Clinical Research Center, Cardiology Division Vanderbilt University Medical Center Nashville TN USA
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA USA
- Framingham Heart Study Framingham MA USA
| | - Gregory D Lewis
- Cardiology Division, Cardiovascular Research Center and Pulmonary Critical Care Unit, Department of Medicine Massachusetts General Hospital Boston MA USA
| | - Matthew Nayor
- Section of Cardiovascular Medicine, Department of Medicine Boston University School of Medicine MA USA
- Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA USA
- Framingham Heart Study Framingham MA USA
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Hernández-Martínez A, Duarte-Junior MA, Sotos-Prieto M, Ortolá R, Banegas JR, Rodríguez-Artalejo F, Soriano-Maldonado A, Martínez-Gómez D. Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:372-380. [PMID: 37783370 DOI: 10.1016/j.rec.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death. METHODS We used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression. RESULTS In total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8 ≤ 49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89). CONCLUSIONS A substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality.
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Affiliation(s)
- Alba Hernández-Martínez
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - Miguel Angelo Duarte-Junior
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Rosario Ortolá
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
| | - Alberto Soriano-Maldonado
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - David Martínez-Gómez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
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Yang T, Yi J, Shao M, Linlin Z, Wang J, Huang F, Guo F, Qin G, Zhao Y. Associations between life's essential 8 and metabolic health among us adults: insights of NHANES from 2005 to 2018. Acta Diabetol 2024:10.1007/s00592-024-02277-2. [PMID: 38583120 DOI: 10.1007/s00592-024-02277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/19/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Metabolic unhealth (MUH) is closely associated with cardiovascular disease (CVD). Life's Essential 8 (LE8), a recently updated cardiovascular health (CVH) assessment, has some overlapping indicators with MUH but is more comprehensive and complicated than MUH. Given the close relationship between them, it is important to compare these two measurements. METHODS This population-based cross-sectional survey included 20- to 80-year-old individuals from 7 National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Based on the parameters provided by the American Heart Association, the LE8 score (which ranges from 0 to 100) was used to classify CVH into three categories: low (0-49), moderate (50-79), and high (80-100). The MUH status was evaluated by blood glucose, blood pressure, and blood lipids. The associations were assessed by multivariable regression analysis, subgroup analysis, restricted cubic spline models, and sensitivity analysis. RESULTS A total of 22,582 participants were enrolled (median of age was 45 years old), among them, 11,127 were female (weighted percentage, 49%) and 16,595 were classified as MUH (weighted percentage, 73.5%). The weighted median LE8 scores of metabolic health (MH) and MUH individuals are 73.75 and 59.38, respectively. Higher LE8 scores were linked to lower risks of MUH (odds ratio [OR] for every 10 scores increase, 0.53; 95% CI 0.51-0.55), and a nonlinear dose-response relationship was seen after the adjustment of potential confounders. This negative correlation between LE8 scores, and MUH was strengthened among elderly population. CONCLUSIONS Higher LE8 and its subscales scores were inversely and nonlinearly linked with the lower presence of MUH. MUH is consistent with LE8 scores, which can be considered as an alternative indicator when it is difficult to collect the information of health behaviors.
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Affiliation(s)
- Tongyue Yang
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Jiayi Yi
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Mingwei Shao
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhao Linlin
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Jiao Wang
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Fengjuan Huang
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Feng Guo
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Guijun Qin
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yanyan Zhao
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Li W, Xing A, Lamballais S, Xu W, Chen S, Zhou S, Wu S, Chen Z. Changes in Life's Essential 8 and risk of cardiovascular disease in Chinese people. Eur J Public Health 2024:ckae063. [PMID: 38573176 DOI: 10.1093/eurpub/ckae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The American Heart Association recently released an updated algorithm for evaluating cardiovascular health-Life's Essential 8 (LE8). However, the associations between changes in LE8 score over time and risk of cardiovascular disease (CVD) remain unclear. METHODS We investigated associations between 6-year changes (2006-12) in LE8 score and risk of subsequent CVD events (2012-20) among 53 363 Chinese men and women from the Kailuan Study, who were free from CVD in 2012. The LE8 score was calculated based on eight components: diet quality, physical activity, smoking status, sleep health, body mass index, blood lipids, blood glucose and blood pressure. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS We documented 4281 incident CVD cases during a median of 7.7 years of follow-up. Compared with participants whose LE8 scores remained stable in a 6-year period, those with the large increases of LE8 score over the 6-year period had a lower risk of CVD, heart disease and stroke in the subsequent 8 years [HRs and 95% CIs: 0.67 (0.64, 0.70) for CVD, 0.65 (0.61, 0.69) for heart disease, 0.71 (0.67, 0.76) for stroke, all Ptrend < 0.001]. Conversely, those with the large decreases of LE8 score had 47%, 51% and 41% higher risk for CVD, heart disease and stroke, respectively. These associations were consistent across the subgroups stratified by risk factors. CONCLUSIONS Improving LE8 score in a short- and moderate-term was associated with a lower CVD risk, whereas decreased LE8 score over time was associated with a higher risk.
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Affiliation(s)
- Wenjuan Li
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Sander Lamballais
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wenqi Xu
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shenghua Zhou
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Zhangling Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Cardiometabolic Medicine, Changsha, Hunan, China
- FuRong Laboratory, Changsha, Hunan, China
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Ruan YX, Wu MX, Gao JW, Guo DC, Cai YW, Huang ZG, He WB, Chen YX, Wang JF, Zhang HF. AHA Life's Essential 8 and new-onset CKD: a prospective cohort study from the UK Biobank. Clin Exp Nephrol 2024; 28:325-336. [PMID: 38151608 DOI: 10.1007/s10157-023-02440-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/19/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND The AHA has recently introduced a novel metric, Life's Essential 8, to assess cardiovascular health (CVH). Nevertheless, the association between varying levels of LE8 and the propensity for CKD is still unclear from a large prospective cohort. Our objective is to meticulously examine the relationship between LE8 and its associated susceptibilities to CKD. METHODS A total of 251,825 participants free of CKD from the UK Biobank were included. Cardiovascular health was scored using LE8 and categorized as low, moderate, and high. Cox proportional hazard models were employed to evaluate the associations of LE8 scores with new-onset CKD. The genetic risk score for CKD was calculated by a weighted method. RESULTS Over a median follow-up of 12.8 years, we meticulously documented 10,124 incident cases of CKD. Remarkably, an increased LE8 score correlated with a significant reduction of risk in new-onset CKD (high LE8 score vs. low LE8 score: HR = 0.300, 95% CI 0.270-0.330, p < 0.001; median LE8 score vs. low LE8 score: HR = 0.531, 95% CI 0.487-0.580, p < 0.001). This strong LE8-CKD association remained robust in extensive subgroup assessments and sensitivity analysis. Additionally, these noteworthy associations between LE8 scores and CKD remained unaffected by genetic predispositions to CKD. CONCLUSIONS An elevated degree of CVH, as delineated by the discerning metric LE8, exhibited a pronounced and statistically significant correlation with a marked reduction in the likelihood of CKD occurrence.
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Affiliation(s)
- Yong-Xiang Ruan
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Mao-Xiong Wu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jing-Wei Gao
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Da-Chuan Guo
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yang-Wei Cai
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Ze-Gui Huang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Wan-Bing He
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yang-Xin Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China.
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China.
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China.
- Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
- Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
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Huang ZG, Gao JW, Zhang HF, You S, Xiong ZC, Wu YB, Guo DC, Wang JF, Chen YX, Zhang SL, Liu PM. Cardiovascular health metrics defined by Life's Essential 8 scores and subsequent macrovascular and microvascular complications in individuals with type 2 diabetes: A prospective cohort study. Diabetes Obes Metab 2024. [PMID: 38558498 DOI: 10.1111/dom.15583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
AIM To investigate the association between cardiovascular health metrics defined by Life's Essential 8 (LE8) scores and vascular complications among individuals with type 2 diabetes (T2D). MATERIALS AND METHODS This prospective study included 11 033 participants with T2D, all devoid of macrovascular diseases (including cardiovascular and peripheral artery disease) and microvascular complications (e.g. diabetic retinopathy, neuropathy and nephropathy) at baseline from the UK Biobank. The LE8 score comprised eight metrics: smoking, body mass index, physical activity, non-high-density lipoprotein cholesterol, blood pressure, glycated haemoglobin, diet and sleep duration. Cox proportional hazards models were established to assess the associations of LE8 scores with incident macrovascular and microvascular complications. RESULTS During a median follow-up of 12.1 years, we identified 1975 cases of incident macrovascular diseases and 1797 cases of incident microvascular complications. After adjusting for potential confounders, each 10-point increase in the LE8 score was associated with an 18% lower risk of macrovascular diseases and a 15% lower risk of microvascular complications. Comparing individuals in the highest and lowest quartiles of LE8 scores revealed hazard ratios of 0.55 (95% confidence interval 0.47-0.62) for incident macrovascular diseases, and 0.61 (95% confidence interval 0.53-0.70) for incident microvascular complications. This association remained robust across a series of sensitivity analyses and nearly all subgroups. CONCLUSION Higher LE8 scores were associated with a lower risk of incident macrovascular and microvascular complications among individuals with T2D. These findings underscore the significance of adopting fundamental strategies to maintain optimal cardiovascular health and curtail the risk of developing diabetic vascular complications.
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Affiliation(s)
- Ze-Gui Huang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing-Wei Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Si You
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuo-Chao Xiong
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu-Biao Wu
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Da-Chuan Guo
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yang-Xin Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shao-Ling Zhang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pin-Ming Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Howard G, Cushman M, Blair J, Wilson NR, Yuan Y, Safford MM, Levitan EB, Judd SE, Howard VJ. Comparative Discrimination of Life's Simple 7 and Life's Essential 8 to Stratify Cardiovascular Risk: Is the Added Complexity Worth It? Circulation 2024; 149:905-913. [PMID: 37830200 PMCID: PMC10948319 DOI: 10.1161/circulationaha.123.065472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Life's Simple 7 (LS7) is an easily calculated and interpreted metric of cardiovascular health based on 7 domains: smoking, diet, physical activity, body mass index, blood pressure, cholesterol, and fasting glucose. The Life's Essential 8 (LE8) metric was subsequently introduced, adding sleep metrics and revisions of the previous 7 domains. Although calculating LE8 requires additional information, we hypothesized that it would be a more reliable index of cardiovascular health. METHODS Both the LS7 and LE8 metrics yield scores with higher values indicating lower risk. These were calculated among 11 609 Black and White participants free of baseline cardiovascular disease (CVD) in the Reasons for Geographic and Racial Differences in Stroke study, enrolled in 2003 to 2007, and followed for a median of 13 years. Differences in 10-year risk of incident CVD (coronary heart disease or stroke) were calculated as a function LS7, and LE8 scores were calculated using Kaplan-Meier and proportional hazards analyses. Differences in incident CVD discrimination were quantified by difference in the c-statistic. RESULTS For both LS7 and LE8, the 10-year risk was approximately 5% for participants around the 99th percentile of scores, and a 4× higher 20% risk for participants around the first percentile. Comparing LS7 to LE8, 10-year risk was nearly identical for individuals at the same relative position in score distribution. For example, the "cluster" of 2013 participants with an LS7 score of 7 was at the 35.8th percentile in distribution of LS7 scores, and had an estimated 10-year CVD risk of 8.4% (95% CI, 7.2%-9.8%). In a similar location in the LE8 distribution, the 1457 participants with an LE8 score of 60±2.5 at the 39.4th percentile of LE8 scores had a 10-year risk of CVD of 8.5% (95% CI, 7.1%-10.1%), similar to the cluster defined by LS7. The age-race-sex adjusted c-statistic of the LS7 model was 0.691 (95% CI, 0.667-0.705), and 0.695 for LE8 (95% CI, 0.681-0.709) (P for difference, 0.12). CONCLUSIONS Both LS7 and LE8 were associated with incident CVD, with discrimination of the 2 indices practically indistinguishable. As a simpler metric, LS7 may be favored for use by the general population and clinicians.
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Affiliation(s)
- George Howard
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Mary Cushman
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, VT
| | - Jessica Blair
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Nicole R. Wilson
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Ya Yuan
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Monika M. Safford
- Department of Internal Medicine, Weill Cornell Medical Center, New York, NY
| | - Emily B. Levitan
- Department of Epidemiology, UAB School of Public Health, Birmingham, AL
| | - Suzanne E. Judd
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
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Sterpetti AV, Gabriele R, Iannone I, Sapienza P, Marzo LD. The role of education and information to prevent trends towards increase of cardiovascular mortality rates in Europe from 2015 TO 2019. Curr Probl Cardiol 2024; 49:102415. [PMID: 38253115 DOI: 10.1016/j.cpcardiol.2024.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND In Europe Cardio Vascular Disease (CVD) mortality rates decreased significantly in the last 25 years, with less decline in the last 5 years. The aim of our study was to analyze trends of risk factors which may explain plateauing of CVD mortality rates in the period 2015-2019 in Europe. METHODS We analyzed data from the Global Burden Disease and EUROSTAT concerning trends of CVD mortality rates for 25 European countries and simultaneous changes of exposure to risk factors of the population RESULTS: CVD related mortality decreased significantly in the analyzed countries in the period 2000-2015; in the period 2015-2019 there was a trend towards plateauing of CVD related mortality rates, which was associated with an increased exposure to several established risk factors including cigarette smoking, obesity and arterial hypertension. A decrease in expenditure for information, education and counseling programs was documented in most countries in the same period. Level of exposure to risk factors was correlated with educational attainment . Exposure to risk factors in the interval 2014-2019 increased for people with lower education, whereas decreased in people with higher education (p<0.001). CONCLUSIONS Organized information about risk factors for CVD have the potential to reduce mortality and burden, with diminished total health expenses. Education and information in this setting should consider the cultural and social level of the public.
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Affiliation(s)
- Antonio V Sterpetti
- Department of Surgery, Sapienza University, Policlinico Umberto I, Viale del Policlinico 00167, Rome, Italy.
| | - Raimondo Gabriele
- Department of Surgery, Sapienza University, Policlinico Umberto I, Viale del Policlinico 00167, Rome, Italy
| | - Immacolata Iannone
- Department of Surgery, Sapienza University, Policlinico Umberto I, Viale del Policlinico 00167, Rome, Italy
| | - Paolo Sapienza
- Department of Surgery, Sapienza University, Policlinico Umberto I, Viale del Policlinico 00167, Rome, Italy
| | - Luca Di Marzo
- Department of Vascular Surgery, Sapienza University, Rome, Italy
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Ferreira NV, Gonçalves NG, Szlejf C, Goulart AC, de Souza Santos I, Duncan BB, Schmidt MI, Barreto SM, Caramelli P, Feter N, Castilhos RM, Drager LF, Lotufo P, Benseñor I, Suemoto CK. Optimal cardiovascular health is associated with slower cognitive decline. Eur J Neurol 2024; 31:e16139. [PMID: 38015440 DOI: 10.1111/ene.16139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Life's Simple 7, a lifestyle and cardiovascular index associated with cognition, has been updated to Life's Essential 8 (LE8) to include sleep. LE8 has been related to cardiovascular outcomes but its association with cognition is unclear. METHODS In this longitudinal analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), LE8 score was based on health behaviors (diet, physical activity, nicotine exposure, and sleep health) as well as health-related factors (body mass index, blood lipids, blood glucose, and blood pressure). Cognition was assessed in three waves, 4 years apart, using the Consortium to Establish a Registry for Alzheimer's Disease - Word List, semantic and phonemic verbal fluency, the Trail-Making Test B (TMT-B), and a global composite score. We used linear mixed-model analysis, inverse probability weighting, and interaction analysis. RESULTS At baseline, the mean age of the study cohort was 51.4 ± 8.9 years, 56% were women, and 53% were White. Higher baseline LE8 scores were associated with slower decline in global cognition (β = 0.001, 95% confidence interval [CI] 0.001, 0.002; p < 0.001), memory (β = 0.001, 95% CI 0.000, 0.002; p = 0.013), verbal fluency (β = 0.001, 95% CI 0.000, 0.002; p = 0.003), and TMT-B (β = 0.004, 95% CI 0.003, 0.005; p < 0.001). This association was mainly driven by LE8 health factors, particularly blood glucose and blood pressure. Age, sex, and race were modifiers of the association between LE8 and global cognitive decline (p < 0.001), suggesting it was more pronounced in older, male, and Black participants. CONCLUSIONS Higher baseline LE8 scores were associated with slower global and domain-specific cognitive decline during 8 years of follow-up, mainly due to health factors such as blood glucose and blood pressure. Sociodemographic factors were modifiers of this association.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculdade Adventista da Amazonia, Benevides, Brazil
| | | | - Claudia Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Itamar de Souza Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandhi Maria Barreto
- Deparment of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luciano F Drager
- Unidade de Hipertensão, Instituto do Coracao (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Chen X, Sun J, Zeng C, Jin F, Ma S, Song J, Chen Z. Association between life's essential 8 and periodontitis: a population-based study. BMC Oral Health 2024; 24:19. [PMID: 38178120 PMCID: PMC10768279 DOI: 10.1186/s12903-023-03816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The American Heart Association has developed a novel cardiovascular health indicator called Life's Essential 8 (LE8). However, no one has reported using LE8 to assess periodontitis. This study aimed to investigate the association between LE8 and periodontitis in American adults. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014 were used for this investigation. LE8 was the independent variable, and it is divided into three grades: high, moderate, and low. Periodontitis was the dependent variable, and the classification of periodontitis was based on the criteria of Eke in 2012. Multivariable logistic regression models were used to explore the relationship between LE8 and periodontitis. RESULTS A total of 9,039 participants with an average age of 52.16 ± 14.21 years were enrolled in this study, of whom 48.29% were male and 51.71% were female. The mean and standard deviation of LE8 was 66.29 ± 14.57, and the prevalence of periodontitis was 50.48% overall. The LE8 score and periodontitis in the fully adjusted logistic regression model showed a negative correlation (OR = 0.98; 95% CI, 0.98-0.99, p < 0.001). This result persisted when Life's Essential 8 was categorized into low, moderate, and high groups. Compared with those in the lowest group, those in the highest LE8 group had a 47% decreased risk of periodontitis (OR = 0.53; 95% CI, 0.46-0.66, P < 0.001). CONCLUSIONS This cross-sectional investigation revealed a negative relationship between the LE8 score and the likelihood of periodontitis.
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Affiliation(s)
- XingJin Chen
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Endodontics, Guiyang Stomatological Hospital, 253 Jiefang Road, Nanming District, Guiyang, 550005, China
| | - JiangLing Sun
- Department of Endodontics, Guiyang Stomatological Hospital, 253 Jiefang Road, Nanming District, Guiyang, 550005, China
| | - ChongWen Zeng
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Endodontics, Guiyang Stomatological Hospital, 253 Jiefang Road, Nanming District, Guiyang, 550005, China
| | - FuQian Jin
- Department of Endodontics, Guiyang Stomatological Hospital, 253 Jiefang Road, Nanming District, Guiyang, 550005, China
| | - Shu Ma
- Department of Endodontics, Guiyang Stomatological Hospital, 253 Jiefang Road, Nanming District, Guiyang, 550005, China
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, No. 9, Beijing Road, Yunyan District, Guiyang, 550002, China.
| | - Zhu Chen
- School of Stomatology, Zunyi Medical University, Zunyi, China.
- Department of Endodontics, Guiyang Stomatological Hospital, 253 Jiefang Road, Nanming District, Guiyang, 550005, China.
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Donofry SD, Jouppi RJ, Call CC, Conlon RPK, Levine MD. Improvements in cardiovascular health over the perinatal period predicts lower postpartum psychological distress. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.22.23300475. [PMID: 38234856 PMCID: PMC10793538 DOI: 10.1101/2023.12.22.23300475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Background Adverse cardiovascular events during pregnancy (e.g., pre-eclampsia) occur at higher rates among individuals with pre-pregnancy overweight or obesity (body mass index [BMI]≥25kg/m2) and have been associated with postpartum depression. However, it is unclear whether cardiovascular health (CVH), defined more holistically than the absence of cardiovascular conditions in pregnancy, relates to postpartum psychological functioning. The present study examined whether changes in CVH during the perinatal period predicted postpartum psychological functioning among individuals with pre-pregnancy BMI≥25kg/m2. Methods Individuals (N=226; Mage=28.43±5.4 years; MBMI=34.17±7.15kg/m2) were recruited when their pregnancies were 12-20 weeks gestation (M=15.64±2.45 weeks) for a longitudinal study of health and well-being. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS) and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6-months postpartum. BMI and CVH behaviors were coded according to the American Heart Association's Life's Essential 8 to create a CVH score at both timepoints. Linear regression analyses were performed to examine whether change in CVH related to postpartum CES-D and PSS scores. Because sleep was only measured in a subset of participants (n=114), analyses were conducted with and without sleep included. Baseline CVH, CES-D and PSS scores, and demographic factors were included as covariates in all models. Results Improved CVH was associated with lower postpartum CES-D (β=-0.18, p<0.01) and PSS (β=-0.13, p=0.02) scores when excluding sleep. Compared to those whose CVH improved by >1SD from pregnancy to 6-months postpartum, individuals whose CVH worsened by >1SD scored 6.42 points higher on the CESD (MCESD=15.25±10.92 vs. 8.52±6.90) and 6.12 points higher on the PSS (MPSS=24.45±8.29 vs. 17.83±8.70). However, when including sleep, these relationships were no longer significant (ps>0.4). Conclusions Improvements in CVH from early pregnancy to 6-months postpartum were associated with lower postpartum depressive symptoms and perceived stress. However, these relationships were no longer significant when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.
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Affiliation(s)
- Shannon D. Donofry
- RAND Corporation, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Riley J. Jouppi
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Christine C. Call
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Michele D. Levine
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
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Joseph JJ, Williams A, Azap RA, Zhao S, Brock G, Kline D, Odei JB, Foraker R, Sims M, Brewer LC, Gray DM, Nolan TS. Role of Sex in the Association of Socioeconomic Status With Cardiovascular Health in Black Americans: The Jackson Heart Study. J Am Heart Assoc 2023; 12:e030695. [PMID: 38038179 PMCID: PMC10727326 DOI: 10.1161/jaha.123.030695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/25/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Socioeconomic status (SES) is associated with cardiovascular health (CVH). Potential differences by sex in this association remain incompletely understood in Black Americans, where SES disparities are posited to be partially responsible for cardiovascular inequities. The association of SES measures (income, education, occupation, and insurance) with CVH scores was examined in the Jackson Heart Study. METHODS AND RESULTS American Heart Association CVH components (non-high-density-lipoprotein cholesterol, blood pressure, diet, tobacco use, physical activity, sleep, glycemia, and body mass index) were scored cross-sectionally at baseline (scale: 0-100). Differences in CVH and 95% CIs (Estimate, 95% CI) were calculated using linear regression, adjusting for age, sex, and discrimination. Heterogeneity by sex was assessed. Participants had a mean age of 54.8 years (SD 12.6 years), and 65% were women. Lower income, education, occupation (non-management/professional versus management/professional occupations), and insurance status (uninsured, Medicaid, Veterans Affairs, or Medicare versus private insurance) were associated with lower CVH scores (all P<0.01). There was heterogeneity by sex, with greater magnitude of associations of SES measures with CVH in women versus men. The lowest education level (high school) was associated with 8.8-point lower (95% CI: -10.2 to -7.3) and 5.4-point lower (95% CI: -7.2 to -3.6) CVH scores in women and men, respectively (interaction P=0.003). The lowest (<25 000) versus highest level of income (≥$75 000) was associated with a greater reduction in CVH scores in women than men (interaction P=0.1142). CONCLUSIONS Among Black Americans, measures of SES were associated with CVH, with a greater magnitude in women compared with men for education and income. Interventions aimed to address CVH through SES should consider the role of sex.
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Affiliation(s)
| | | | | | - Songzhu Zhao
- The Ohio State University College of MedicineColumbusOHUSA
| | - Guy Brock
- The Ohio State University College of MedicineColumbusOHUSA
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health SciencesWake Forest School of MedicineWinston‐SalemNCUSA
| | - James B. Odei
- The Ohio State University College of Public HealthColumbusOHUSA
| | - Randi Foraker
- Department of Internal Medicine and Institute for InformaticsWashington University in St. Louis School of MedicineSt. LouisMOUSA
| | | | - LaPrincess C. Brewer
- Department of Cardiovascular MedicineCenter for Health Equity and Community Engagement Research, Mayo ClinicRochesterMNUSA
| | - Darrell M. Gray
- Elevance Health (formerly of The Ohio State University Wexner Medical Center)IndianapolisINUSA
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Rempakos A, Prescott B, Mitchell GF, Vasan RS, Xanthakis V. Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study. J Am Heart Assoc 2023; 12:e030764. [PMID: 38014669 PMCID: PMC10727315 DOI: 10.1161/jaha.123.030764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The association of the American Heart Association's updated cardiovascular health score, the Life's Essential 8 (LE8), with cardiovascular disease (CVD) and death is not described in the FHS (Framingham Heart Study). METHODS AND RESULTS We evaluated Framingham Offspring participants at examinations 2 and 6 (n=2888 and 1667; and mean age, 44 and 57 years, respectively), free of CVD with information on LE8 components. Using age-sex-adjusted Cox models, we related LE8 and its change (examination 2 to examination 6) with CVD and death risk and compared associations with those of the Life's Simple 7 score. Mean LE8 score at examination 2 was 67 points (minimum, 26 points; maximum, 100 points). At both examinations, participants were reclassified to a different cardiovascular health status, depending on which method (LE8 versus Life's Simple 7) was used (60% of participants in ideal Life's Simple 7 status were in intermediate LE8 category). On follow-up after examination 2 (median, 30 and 33 years for CVD and death, respectively), we observed 966 CVD events, and 1195 participants died. Participants having LE8≥68 (sample median) were at lower CVD and death risk compared with those with LE8<68 (examination 2: CVD hazard ratio [HR], 0.47 [95% CI, 0.41-0.54]; death HR, 0.55 [95% CI, 0.49-0.62]; all P<0.001). Participants maintaining low LE8 scores during life course were at highest CVD and death risk (CVD: HRs ranging from 1.8 to 2.3; P<0.001; death HR, 1.45 [95% CI, 1.13-1.85]; P=0.003 versus high-high group). CONCLUSIONS Further studies are warranted to elucidate whether the LE8 score is a better marker of CVD and death risk, compared with Life's Simple 7 score.
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Affiliation(s)
| | - Brenton Prescott
- Section of Preventive Medicine and Epidemiology, Department of MedicineBoston University School of MedicineBostonMA
| | | | - Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Department of MedicineBoston University School of MedicineBostonMA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
- Department of EpidemiologyBoston University School of Public HealthBostonMA
- University of Texas School of Public HealthSan AntonioTX
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Department of MedicineBoston University School of MedicineBostonMA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
- Department of BiostatisticsBoston University School of Public HealthBostonMA
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Isiozor NM, Laukkanen JA, Voutilainen A, Bensenor IM, Kunutsor SK. Life's Essential 8 is associated with atherosclerotic cardiovascular disease but not venous thromboembolism in men: a prospective cohort study. Ann Med 2023; 55:2233894. [PMID: 37459575 DOI: 10.1080/07853890.2023.2233894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
Background: Atherosclerotic cardiovascular disease (ASCVD) shares several risk factors with venous thromboembolism (VTE). The American Heart Association's Life's Simple 7 (LS7), which included seven health and behavioural factors for CVD prevention, has recently been upgraded to Life's Essential 8 (LE8) score. We aimed to examine the prospective association between LE8 and the risks of ASCVD and VTE in Finland.Methods: We utilized data based on 1899 men aged 42-61 years in the Kuopio Ischaemic Heart Disease (KIHD) prospective study. The LE8 score was generated from baselines measures of four health behaviours (physical activity, diet, nicotine exposure and sleep health) and four health factors (BMI, blood lipids, blood glucose and blood pressure). Each factor was scored from 0 to 100 and summed into a composite score. Participants were classified into quartiles (Q) based on the total LE8 score - Q1, ≤ 420; Q2, >420 to 485; Q3, >485 to 550; Q4, >550. Multivariable Cox regression models were utilized to determine the hazard ratios (HRs) along with the 95% confidence intervals (CI) for ASCVD and VTE.Results: After median follow-up durations of 24 and 25 years, 889 ASCVD and 127 VTE events were recorded, respectively. The risk of ASCVD was found to be 58% lower in men belonging to the highest LE8 quartile compared to those in the lowest quartile (HR:0.42; 95%CI: 0.34-0.51). There was no significant evidence of an association between LE8 and VTE risk (Q4 vs Q1, HR:1.02; 95%CI: 0.60-1.74).Conclusion: The risk of ASCVD was significantly lower in middle-aged and older Finnish men who had a high LE8 score, but there was no significant association with VTE. Further large-scale prospective studies conducted in women and other population groups are necessary to confirm these findings.
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Affiliation(s)
- Nzechukwu M Isiozor
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Internal Medicine, Central Finland Health Care District, Jyvaskyla, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Setor K Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
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Petermann-Rocha F, Deo S, Lyall D, Orkaby AR, Quinn TJ, Sattar N, Celis-Morales C, Pell JP, Ho FK. Association Between the AHA Life's Essential 8 Score and Incident All-Cause Dementia: A Prospective Cohort Study from UK Biobank. Curr Probl Cardiol 2023; 48:101934. [PMID: 37422047 DOI: 10.1016/j.cpcardiol.2023.101934] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Abstract
This study aimed to investigate the association between the Life's Essential 8 (LE8) score and incident all-cause dementia (including Alzheimer's disease [AD] and vascular dementia) in UK Biobank. A total of 259,718 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet, and sleep were used to create the Life's Essential 8 (LE8) score. Associations between the score (both continuous and as quartiles) and outcomes were investigated using adjusted Cox proportional hazard models. The potential impact fractions of 2 scenarios and the rate advancement periods were also calculated. Over a median follow-up of 10.6 years, 4958 participants were diagnosed with any dementia. Higher LE8 scores were associated with lower risk of all-cause and vascular dementia in an exponential decay pattern. Compared with individuals in the healthiest quartile, those in the least healthy quartile had a higher risk of all-cause dementia (HR: 1.50 [95% CI: 1.37-1.65] and vascular dementia (HR: 1.86 [1.44-2.42]). A targeted intervention that increased the score by 10-points among individuals in the lowest quartile could have prevented 6.8% of all-cause dementia cases. Individuals in the least healthy LE8 quartile might develop all-cause dementia 2.45 years earlier than their counterparts. In conclusion, individuals with higher LE8 scores had lower risk of all-cause and vascular dementia. Because of nonlinear associations, interventions targeted at the least healthy individuals might produce greater population-level benefits.
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Affiliation(s)
- Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Salil Deo
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Division of Cardiothoracic Surgery Surgical Services, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Case School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Donald Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Ariela R Orkaby
- New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA; Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Terence J Quinn
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
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Zhang J, Chen G, Habudele Z, Wang X, Cai M, Li H, Gao Y, Lip GYH, Lin H. Relation of Life's Essential 8 to the genetic predisposition for cardiovascular outcomes and all-cause mortality: results from a national prospective cohort. Eur J Prev Cardiol 2023; 30:1676-1685. [PMID: 37228091 DOI: 10.1093/eurjpc/zwad179] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/01/2023] [Accepted: 05/20/2023] [Indexed: 05/27/2023]
Abstract
AIMS To evaluate the independent, mediating, interactive, and associated effects of Life's Essential 8 (LE8) and genetic predisposition on the risk of cardiovascular outcomes and all-cause mortality. METHODS AND RESULTS We retrieved a total of 254 783 individuals from the UK Biobank. LE8 was determined by eight metrics (nicotine exposure, physical activity, diet, sleep, body mass index, blood pressure, blood glucose, and blood lipids), and was characterized as low, moderate, and high cardiovascular health (CVH). Genetic predisposition was estimated using the polygenic risk score (PRS). Cox regressions were performed to evaluate the associations between LE8, PRS, and outcomes. During a median follow-up of 12.53 years, all-cause mortality occurred in 10 257 of 197 473 participants, cardiovascular mortality in 2074 of 215 675, and incident cardiovascular disease (CVD) in 71 774 of 215 675. Individuals with moderate or high CVH experienced a lower risk [hazard ratios (HRs) 0.33 to 0.81] of adverse health outcomes compared with their counterparts with low CVH. A substantial proportion (16.1∼69.8%) of health outcomes could be attributable to moderate or high LE8, and up to 51.2% of the associations between PRS and adverse outcomes were mediated by LE8. In high PRS group, individuals with high CVH had lower CVD mortality (HR: 0.26, 95% confidence interval: 0.18, 0.39), compared to those with low CVH. CONCLUSION Ideal CVH was associated with lower risks of cardiovascular outcomes and all-cause mortality, with a more pronounced association observed in individuals with high PRS for CVD. Improving CVH according to LE8 guidelines should be encouraged, especially for those with PRS that indicate high CVD risk.
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Affiliation(s)
- Junguo Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Ge Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Zierdi Habudele
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yanhui Gao
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
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Wu HX, Chu TY, Iqbal J, Jiang HL, Li L, Wu YX, Zhou HD. Cardio-cerebrovascular Outcomes in MODY, Type 1 Diabetes, and Type 2 Diabetes: A Prospective Cohort Study. J Clin Endocrinol Metab 2023; 108:2970-2980. [PMID: 37093977 DOI: 10.1210/clinem/dgad233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/09/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
CONTEXT Cardio-cerebrovascular events are severe complications of diabetes. OBJECTIVE We aim to compare the incident risk of cardio-cerebrovascular events in maturity onset diabetes of the young (MODY), type 1 diabetes, and type 2 diabetes. METHODS Type 1 diabetes, type 2 diabetes, and MODY were diagnosed by whole exome sequencing. The primary endpoint was the occurrence of the first major adverse cardiovascular event (MACE), including acute myocardial infarction, heart failure, stroke, unstable angina pectoris, and cardio-cerebrovascular-related mortality. Cox proportional hazards models were applied and adjusted to calculate hazard ratios (HRs) and 95% CIs for the incident risk of MACE in type 1 diabetes, type 2 diabetes, MODY, and MODY subgroups compared with people without diabetes (control group). RESULTS Type 1 diabetes, type 2 diabetes, and MODY accounted for 2.7%, 68.1%, and 11.4% of 26 198 participants with diabetes from UK Biobank. During a median follow-up of 13 years, 1028 MACEs occurred in the control group, contrasting with 70 events in patients with type 1 diabetes (HR 2.15, 95% CI 1.69-2.74, P < .05), 5020 events in patients with type 2 diabetes (HR 7.02, 95% CI 6.56-7.51, P < .05), and 717 events in MODY (HR 5.79, 95% CI 5.26-6.37, P < .05). The hazard of MACE in HNF1B-MODY was highest among MODY subgroups (HR 11.00, 95% CI 5.47-22.00, P = 1.5 × 10-11). CONCLUSION MODY diagnosed by genetic analysis represents higher prevalence than the clinical diagnosis in UK Biobank. The risk of incident cardio-cerebrovascular events in MODY ranks between type 1 diabetes and type 2 diabetes.
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Affiliation(s)
- Hui-Xuan Wu
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, Key Laboratory of Diabetes Immunology Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Tian-Yao Chu
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 41000, Hunan, China
| | - Junaid Iqbal
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, Key Laboratory of Diabetes Immunology Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hong-Li Jiang
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, Key Laboratory of Diabetes Immunology Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Long Li
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, Key Laboratory of Diabetes Immunology Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yan-Xuan Wu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 15000, China
| | - Hou-De Zhou
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, Key Laboratory of Diabetes Immunology Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
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Wang S, Shin DB, Bhutani T, Garshick MS, Gelfand JM. Cardiovascular Health in People with Psoriasis: A Population-Based Study in the United States. J Invest Dermatol 2023; 143:2075-2078. [PMID: 37088279 DOI: 10.1016/j.jid.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Sonia Wang
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel B Shin
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Michael S Garshick
- Leon H. Charney Division of Cardiology, Department of Medicine, New York University Langone Health System, New York, New York, USA; Ronald O. Perelman Department of Dermatology, New York University Langone Health System, New York, New York, USA
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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21
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Chen H, Tang H, Huang J, Luo N, Zhang X, Wang X. Life's Essential 8 and Mortality in US Adults with Chronic Kidney Disease. Am J Nephrol 2023; 54:516-527. [PMID: 37591229 DOI: 10.1159/000533257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION The current prevalence of chronic kidney disease (CKD) is substantial, and CKD individuals face a heightened risk of mortality, encompassing both all-cause and cause-specific outcomes. The current study aims to investigate the potential impact of adhering to Life's Essential 8 (LE8) on reducing mortality among CKD individuals. METHODS Using the National Health and Nutrition Survey (NHANES) data from 2005 to 2018, we analyzed 22,420 US adults (≥20 years old). CKD is defined by urinary albumin-to-creatinine ratio (≥30 mg/g or 3 mg/mmol) and estimated glomerular filtration rate (<60 mL/min/1.73 m2). The components of LE8, including diet, physical activity (PA), nicotine exposure, sleep, body mass index, blood lipids, blood glucose, and blood pressure (BP), were measured and given a score of 0-100. The total LE8 score was the unweighted average of all components and was divided into low cardiovascular health (CVH) (0-49), moderate CVH (50-79), and high CVH (80-100). A Cox proportional hazards regression model was used to explore the associations of LE8 with all-cause, cardiovascular disease (CVD), and cancer mortality, which were followed prospectively by the National Center for Health Statistics until December 31, 2019. RESULTS In the overall population, individuals with moderate CVH had a 47% lower risk of CKD, while high CVH was linked to a 55% lower risk compared to low CVH. During a median follow-up of 7.58 years, CKD individuals had a 93% higher all-cause mortality rate and a 149% higher CVD mortality rate compared to those without CKD. Among the CKD individuals, every 10-point increase in the LE8 score was associated with reduced risks of 17% for all-cause mortality (especially PA, nicotine exposure, blood glucose, and BP), 18% for CVD mortality (especially PA), and 12% for cancer mortality (especially PA and sleep health). In additional and sensitivity analysis, the results remained significant after further consideration of potential confounding of renal function. Additionally, LE8 demonstrated superior risk stratification for CVD mortality among CKD patients compared with LS7. Interaction was observed between LE8 and age, education level, marital status, and drinking status. CONCLUSION The current study demonstrates that adherence to higher LE8 levels within CKD individuals is associated with a reduced risk of both all-cause and cause-specific mortality.
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Affiliation(s)
- Hongyu Chen
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Haoxian Tang
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Jingtao Huang
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Nan Luo
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Xuan Zhang
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Xin Wang
- Department of Cardiac Critical Care Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Huang NC, Kuo PH, Hsu WC, Hu SC. Retirement planning and types of healthy lifestyle after retirement: a Nationwide Survey in Taiwan. Health Promot Int 2023; 38:7151548. [PMID: 37140348 DOI: 10.1093/heapro/daad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Limited research has examined the components of retirement planning and the effects on retirees' health behaviors. This study aims to explore whether retirement planning is associated with different types of healthy lifestyles after retirement. We conducted a nationwide Health and Retirement Survey in Taiwan and analyzed the data from 2015 to 2016. A total of 3128 retirees aged 50-74 years were included in the analysis. Twenty items on retirement planning from five categories were administered, and 20 health-related behaviors were used for measuring healthy lifestyles. Results showed that five types of healthy lifestyles were found from the 20 health behaviors by factor analysis. After controlling for all covariates, various components of retirement planning were associated with different types of lifestyles. Retirees having any item of retirement planning would significantly increase the score of 'healthy living'. Those with 1-2 items were also associated with the total score and the type of 'no unhealthy food'. However, those with ≥ 6 items were the only group positively related to the type of 'regular health checkups' but negatively to the type of 'good medication'. In conclusion, retirement planning offers a 'window of opportunity' for promoting healthy lifestyles after retirement. Pre-retirement planning should be advocated in the workplace to improve health-related behaviors, especially for those upcoming retired workers. In addition, a friendly environment and continuous programs should also be incorporated for better retirement life.
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Affiliation(s)
- Nuan-Ching Huang
- Healthy City Research Center, Innovation Headquarters, National Cheng Kung University. No.1, University Road, Tainan, 70101, Taiwan
| | - Pin-Han Kuo
- Department of Medical Service, Standard Chem & Pharm Company, LTD., No. 154, Kaiyuan Rd., Xinying Dist., Tainan City, Taiwan
| | - Wan-Chen Hsu
- Department of Public Health, College of Medicine, National Cheng Kung University. No.1, University Road, Tainan, 70101, Taiwan
| | - Susan C Hu
- Healthy City Research Center, Innovation Headquarters, National Cheng Kung University. No.1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University. No.1, University Road, Tainan, 70101, Taiwan
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Gao X, Ma X, Lin P, Wang Y, Zhao Z, Zhang R, Yu B, Hao Y. Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life's Simple 7 and Life's Essential 8. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3084. [PMID: 36833779 PMCID: PMC9965286 DOI: 10.3390/ijerph20043084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
The American Heart Association recently published an updated algorithm for quantitative assessments of cardiovascular health (CVH) metrics, namely Life's Essential 8 (LE8). This study aimed to compare the predictive value between Life's Simple 7 (LS7) and LE8 and predict the likelihood of major adverse cardiac events (MACEs) in patients undergoing percutaneous coronary intervention (PCI) to determine the utility of the LE8 in predicting CVH outcomes. A total of 339 patients with acute coronary syndrome (ACS) who had undergone PCI were enrolled to assess the CVH scores using the LS7 and LE8. Multivariable Cox regression analysis was employed to evaluate the predictive value of the two different CVH scoring systems at 2 years for MACEs. Multivariable Cox regression analysis revealed that both the LS7 and LE8 scores were protective factors for MACEs (HR = 0.857, [95%CI: 0.78-0.94], HR = 0.964, [95%CI: 0.95-0.98]; p < 0.05, respectively). Receiver operator characteristic analysis indicated that the area under the curve (AUC) of LE8 was higher than that of LS7 (AUC: 0.662 vs. 0.615, p < 0.05). Lastly, in the LE8 score, diet, sleep health, serum glucose levels, nicotine exposure, and physical activity were found to be correlated with MACEs (HR = 0.985, 0.988, 0.993, 0.994, 0.994, respectively). Our study established that LE8 is a more reliable assessment system for CVH. This population-based prospective study reports that an unfavorable cardiovascular health profile is associated with MACEs. Future research is warranted to evaluate the effectiveness of optimizing diet, sleep health, serum glucose levels, nicotine exposure, and physical activity in reducing the risk of MACEs. In conclusion, our findings corroborated the predictive value of Life's Essential 8 and provided further evidence for the association between CVH and the risk of MACEs.
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Affiliation(s)
- Xueqin Gao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin 150086, China
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Xinrui Ma
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Ping Lin
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Zhenjuan Zhao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Rui Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Yanhua Hao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin 150086, China
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