Life's Essential 8 and Risk of All-Cause and Cardiovascular Mortality in US Adults With Arthritis: A Retrospective Cohort Study Utilizing NHANES Database

IF 2.4 4区医学 Q2 RHEUMATOLOGY International Journal of Rheumatic Diseases Pub Date : 2025-02-10 DOI:10.1111/1756-185X.70105

Feiyu Yao, Jiafeng Zhang, Xianhua Li, Meng Sun, Po-Cheng Shih, Tuo Li

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Abstract

Background

Life's Essential 8 (LE8) is a recently updated algorithm for evaluating cardiovascular health (CVH). This study investigates the association between LE8 and mortality risk among individuals with arthritis in the United States.

Methods

We conducted a retrospective cohort study using data from the US National Health and Nutritional Examination Survey (NHANES) 2005–2018. Participants with arthritis were included. Mortality data, including underlying causes of death, were obtained through linkage to national death records up to December 31, 2019. LE8 components (diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, glucose, and pressure) were measured and scored from 0 to 100. The total LE8 score, calculated as the unweighted average of all components, was categorized into low (0–49), moderate (50–79), and high (80–100) CVH. We employed Kaplan–Meier curves to estimate survival probabilities and weighted Cox proportional hazards regression models to evaluate hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause and cardiovascular disease (CVD) mortality. Stratified analyses and interaction tests were performed to explore potential effect modifications.

Results

Among 4519 participants with arthritis (median follow-up: 7.67 years), we observed 793 all-cause deaths, including 213 CVD deaths. Every 10-point increase in the LE8 score was associated with a 17% lower risk of all-cause mortality (HR: 0.83, 95% CI: 0.77–0.89) and a 25% lower risk of CVD mortality (HR: 0.75, 95% CI: 0.66–0.85). Compared to the lowest CVH tertile, individuals in the highest tertile demonstrated a 38% lower risk of all-cause mortality (HR: 0.62, 95% CI: 0.41–0.92) and a 62% lower risk of CVD mortality (HR: 0.38, 95% CI: 0.18–0.80). Kaplan–Meier survival curves revealed significantly higher survival probability for patients with high CVH compared to those with lower CVH (log-rank p < 0.05). Stratified analyses confirmed consistent associations across various subgroups. Similar findings were observed in sensitivity analyses focusing on osteoarthritis and other arthritis subtypes.

Conclusion

Higher adherence to LE8 recommendations is associated with reduced risks of all-cause and cardiovascular mortality among US adults with arthritis.

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来源期刊

International Journal of Rheumatic Diseases RHEUMATOLOGY-

CiteScore

3.70

自引率

4.00%

发文量

362

审稿时长

1 months

期刊介绍： The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.