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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Vydáno v:Journal of the American Heart Association Ročník 12; číslo 23; s. e030764
Hlavní autoři: Rempakos, Athanasios, Prescott, Brenton, Mitchell, Gary F., Vasan, Ramachandran S., Xanthakis, Vanessa
Médium: Journal Article
Jazyk:angličtina
Vydáno: England John Wiley and Sons Inc 05.12.2023
Wiley
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ISSN:2047-9980, 2047-9980
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Abstract 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.
AbstractList 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.
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.
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).BACKGROUNDThe 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 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).METHODS AND RESULTSWe 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).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.CONCLUSIONSFurther 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.
Author Vasan, Ramachandran S.
Rempakos, Athanasios
Prescott, Brenton
Xanthakis, Vanessa
Mitchell, Gary F.
AuthorAffiliation 1 Minneapolis Heart Institute Foundation Minneapolis MN
2 Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA
5 Department of Epidemiology Boston University School of Public Health Boston MA
3 Cardiovascular Engineering, Inc Norwood MA
4 Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study Framingham MA
7 Department of Biostatistics Boston University School of Public Health Boston MA
6 University of Texas School of Public Health San Antonio TX
AuthorAffiliation_xml – name: 3 Cardiovascular Engineering, Inc Norwood MA
– name: 7 Department of Biostatistics Boston University School of Public Health Boston MA
– name: 6 University of Texas School of Public Health San Antonio TX
– name: 5 Department of Epidemiology Boston University School of Public Health Boston MA
– name: 4 Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study Framingham MA
– name: 1 Minneapolis Heart Institute Foundation Minneapolis MN
– name: 2 Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA
Author_xml – sequence: 1
  givenname: Athanasios
  orcidid: 0000-0002-2683-5255
  surname: Rempakos
  fullname: Rempakos, Athanasios
  organization: Minneapolis Heart Institute Foundation Minneapolis MN
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  fullname: Prescott, Brenton
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  givenname: Ramachandran S.
  orcidid: 0000-0001-7357-5970
  surname: Vasan
  fullname: Vasan, Ramachandran S.
  organization: Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA, Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study Framingham MA, Department of Epidemiology Boston University School of Public Health Boston MA, University of Texas School of Public Health San Antonio TX
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  givenname: Vanessa
  orcidid: 0000-0002-7352-621X
  surname: Xanthakis
  fullname: Xanthakis, Vanessa
  organization: Section of Preventive Medicine and Epidemiology, Department of Medicine Boston University School of Medicine Boston MA, Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study Framingham MA, Department of Biostatistics Boston University School of Public Health Boston MA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/38014669$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
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Issue 23
Keywords American Heart Association
cardiovascular disease
ideal cardiovascular health
Life's Essential 8
Language English
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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.
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Snippet The association of the American Heart Association's updated cardiovascular health score, the Life's Essential 8 (LE8), with cardiovascular disease (CVD) and...
Background The association of the American Heart Association's updated cardiovascular health score, the Life's Essential 8 (LE8), with cardiovascular disease...
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SubjectTerms 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
Title Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study
URI https://www.ncbi.nlm.nih.gov/pubmed/38014669
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https://pubmed.ncbi.nlm.nih.gov/PMC10727315
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Volume 12
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