Life’s Essential 8 and Risk of Stroke: A Prospective Community-Based Study

Abstract

BACKGROUND: Data are lacking regarding cardiovascular health (CVH) with Life’s Essential 8 approach and future stroke risk. We sought to elucidate whether the CVH score constructed by the Life’s Essential 8 metrics predicted stroke risk in 2 Chinese ongoing cohorts. METHODS: This included 41 043 participants of the Kailuan I study and 27 842 participants of the Kailuan II study who were free of cardiovascular disease or cancer in 2014. CVH score (ranged from 0 to 100) was assessed using the Life’s Essential 8 metrics (body mass index, cigarette smoking, diet quality, physical activity, sleep health, lipid, blood glucose, and blood pressure). A composite of incident stroke events (ischemic stroke and hemorrhagic stroke) was identified via review of medical records. The follow-up period was calculated from the finishing date of the 2014 survey to either the date of stroke occurrence, death, loss to follow-up, or the end of follow-up (December 31, 2020). We also examined the longitudinal association between the CVH score and arterial stiffness status, as assessed by brachial-ankle pulse wave velocity, in 25 922 participants free of cardiovascular disease during the follow-up. We performed a meta-analysis to assess the association between CVH, based on the 2010 American Heart Association recommendation, and stroke integrating the results of current study and previous studies. RESULTS: During a median follow-up of 5.65 years (interquartile range, 5.20–6.09), a total of 1750 incident stroke events were identified in the pooled Kailuan study. The pooled hazard ratios were 0.33 (95% CI, 0.20–0.54) for ideal versus poor health category of CVH ( P trend <0.0001). Higher CVH scores were also associated with lower brachial-ankle pulse wave velocity values at baseline and slower increments of brachial-ankle pulse wave velocity during follow-up ( P trend ≤0.001 for both). Arterial stiffness mediated 9.07% (95% CI, 5.83%–15.0%) of the total association between CVH and incident stroke. The pooled hazard ratio comparing 2 extreme CVH categories for stroke was 0.45 (95% CI, 0.35–0.59) when including 10 published studies and the current study. CONCLUSIONS: The CVH score as assessed by the Life’s Essential 8 metrics significantly predicted future stroke risk and arterial stiffness status.

Association between kidney stones and life's essential 8: a population-based study

“…As a comprehensive assessment of cardiovascular health (CVH), LE8 is more comprehensive than the previous LS7 score and has been shown to be superior in predicting stroke risk and arterial stiffness. [ 15 , 16 , 21 ]. This study first reveals the potential connection between LE8 scores and the risk of kidney stones, providing a new perspective for further exploration of the value of comprehensive health behaviors and factors in preventing kidney stones.…”

Race/ethnicity-specific association between the American Heart Association's new Life's Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: evidence from NHANES 2005-2018

“…The crude model did not adjust for any covariates; Model 1 was an age-, sex-, and race-adjusted model; and Model 2 was a fully adjusted model that additionally adjusted for education level, PIR, marital status, CHD, family history of CVD, and eGFR in addition to Model 1. In addition, we performed an independent analysis of the association between LE8 and stroke in NAFLD based on the number of optimal LE8 metrics met by participants and strati ed according to behaviors and metabolic factors [19]. The optimal/ideal CVH criterion for each LE8 component is ≥ 80 points [15].…”

“…Although there has been cumulative evidence of a strong association of LE8 with the occurrence of CVD in the general population, few studies have focused on addressing the association of LE8 with stroke. Wu et al [19] demonstrated using two Kailuan cohorts that each 10-point increase in LE8 was associated with a 22% reduction in stroke risk. Similarly, the ideal LE8 component of 3 + in both LE8 metabolic and behavioral factors was associated with the lowest stroke risk.…”

“…Only two real-world studies have focused on the association of LE8 with stroke and its progression. A prospective Chinese cohort study demonstrated that high CVH assessed by LE8 was associated with a signi cantly lower risk of stroke compared with low CVH (hazard ratio [HR] = 0.33) [19].…”

Longitudinal cardiovascular health measured by life's essential 8 metrics with incident diabetes: A 13‐year prospective cohort study

“…The definitions and scoring for CVH metrics are provided in Table S2. 3,4,18 Each individual CVH metric was scored on a scale of 0-100 points, and the overall CVH score ranged from 0 to 100 points was calculated as the average score of the seven the CVH metrics (except FBG). The time-updated mean CVH score was calculated as the mean of all available CVH measurements from baseline to the year before incident diabetes occurred or to the end of the followup.…”