Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study

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). We evaluated Framingham Offspring participants at examinations 2 and 6 (n...

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Published in:Journal of the American Heart Association Vol. 12; no. 23; p. e030764
Main Authors: Rempakos, Athanasios, Prescott, Brenton, Mitchell, Gary F., Vasan, Ramachandran S., Xanthakis, Vanessa
Format: Journal Article
Language:English
Published: England John Wiley and Sons Inc 05.12.2023
Wiley
Subjects:
Adult
American Heart Association
cardiovascular disease
Cardiovascular Diseases - epidemiology
Heart
Humans
ideal cardiovascular health
Life's Essential 8
Longitudinal Studies
Middle Aged
Original Research
Risk Factors
United States - epidemiology
United States
American Heart Association
cardiovascular disease
ideal cardiovascular health
Life's Essential 8
ISSN:2047-9980, 2047-9980
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Summary: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). 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 <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; <0.001; death HR, 1.45 [95% CI, 1.13-1.85]; =0.003 versus high-high group). 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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This article was sent to Yen‐Hung Lin, MD, PhD, Associate Editor, for review by expert referees, editorial decision, and final disposition.
Supplemental Material is available at https://www.ahajournals.org/doi/suppl/10.1161/JAHA.123.030764
For Sources of Funding and Disclosures, see page 10.
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.123.030764