心血管疾病终生风险汇集项目中人生必备的 8 项心血管健康指标与心血管事件之间的关系。

Hongyan Ning, A. Perak, J. Siddique, J. Wilkins, D. Lloyd-Jones, N. Allen
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引用次数: 0

摘要

背景美国心脏协会最近推出了更新的心血管健康指标,称为 "生命必需 8 项指标"(LE8)。与 "生命简约 7"(LS7)相比,新方法增加了睡眠健康作为第八项指标,并更新了其余 7 项健康因素和行为。更新后的 LE8 评分与心血管疾病(CVD)的长期预后和死亡之间的关系尚不清楚。我们分别计算了LE8总分(0-100分)、不含睡眠的LE8得分(0-100分)和先前的LS7得分(0-14分)。我们使用多变量调整 Cox 模型来评估 LE8 与心血管疾病、心血管疾病亚型以及年轻、中年和老年成人全因死亡率之间的关系。结果我们的样本包括 32 896 名美国成年人(7836 名[23.8%] 黑人;14 941 名[45.4%] 男性),随访时间为 642 000 人年,其中 9391 人发生了心血管疾病。LE8总分每提高10分,心血管疾病风险降低22%至40%,先天性心脏病风险降低24%至43%,中风风险降低17%至34%,心力衰竭风险降低23%至38%,各年龄段所有死因风险降低17%至21%。与LS7相比,LE8评分对相关心血管疾病风险的区分更为细致。总体而言,分别有 19.5% 和 15.5% 的研究参与者根据 LE8 和 LS7 分值进行了向上和向下重新分类,除 LS7 分值外,重新分类还与心血管疾病风险显著相关。在LE8和LS7类别之间增加重新分类可改善各年龄组的心血管疾病风险重新分类(临床净重新分类改善率为0.06-0.12;P<0.01)。
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Association Between Life's Essential 8 Cardiovascular Health Metrics With Cardiovascular Events in the Cardiovascular Disease Lifetime Risk Pooling Project.
BACKGROUND The American Heart Association recently launched updated cardiovascular health metrics, termed Life's Essential 8 (LE8). Compared with Life's Simple 7 (LS7), the new approach added sleep health as an eighth metric and updated the remaining 7 health factors and behaviors. The association of the updated LE8 score with long-term cardiovascular disease (CVD) outcomes and death is unknown. METHODS We pooled individual-level data from 6 contemporary US-based cohorts from the Cardiovascular Lifetime Risk Pooling Project. Total LE8 score (0-100 points), LE8 score without sleep (0-100 points), and prior LS7 scores (0-14 points) were calculated separately. We used multivariable-adjusted Cox models to evaluate the association of LE8 with CVD, CVD subtypes, and all-cause mortality among younger, middle, and older adult participants. Net reclassification improvement analysis was used to measure the improvement in CVD risk classification with the addition of LS7 and LE8 recategorization based on score quartile rankings. RESULTS Our sample consisted of 32 896 US adults (7836 [23.8%] Black; 14 941 [45.4%] men) followed for 642 000 person-years, of whom 9391 developed CVD events. Each 10-point higher overall LE8 score was associated with lower risk by 22% to 40% for CVD, 24% to 43% for congenital heart disease, 17% to 34% for stroke, 23% to 38% for heart failure, and 17% to 21% for all causes of mortality events across age strata. LE8 score provided more granular differentiation of the related CVD risk than LS7. Overall, 19.5% and 15.5% of the study participants were recategorized upward and downward based on LE8 versus LS7 categories, respectively, and the recategorization was significantly associated with CVD risk in addition to LS7 score. The addition of recategorization between LE8 and LS7 categories improved CVD risk reclassification across age groups (clinical net reclassification improvement, 0.06-0.12; P<0.01). CONCLUSIONS These findings support the improved utility of the LE8 algorithm for assessing overall cardiovascular health and future CVD risk.
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来源期刊
Circulation. Cardiovascular Quality and Outcomes
Circulation. Cardiovascular Quality and Outcomes Medicine-Cardiology and Cardiovascular Medicine
CiteScore
9.80
自引率
2.90%
发文量
357
期刊介绍: Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, publishes articles related to improving cardiovascular health and health care. Content includes original research, reviews, and case studies relevant to clinical decision-making and healthcare policy. The online-only journal is dedicated to furthering the mission of promoting safe, effective, efficient, equitable, timely, and patient-centered care. Through its articles and contributions, the journal equips you with the knowledge you need to improve clinical care and population health, and allows you to engage in scholarly activities of consequence to the health of the public. Circulation: Cardiovascular Quality and Outcomes considers the following types of articles: Original Research Articles, Data Reports, Methods Papers, Cardiovascular Perspectives, Care Innovations, Novel Statistical Methods, Policy Briefs, Data Visualizations, and Caregiver or Patient Viewpoints.
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