TY - JOUR
T1 - Life's Essential 8 and 10-Year and Lifetime Risk of Atherosclerotic Cardiovascular Disease in China
AU - Jin, Cheng
AU - Li, Jianxin
AU - Liu, Fangchao
AU - Li, Xia
AU - Hui, Ying
AU - Chen, Shouhua
AU - Li, Furong
AU - Wang, Gang
AU - Liang, Fengchao
AU - Lu, Xiangfeng
AU - Wu, Shouling
AU - Gu, Dongfeng
N1 - Publisher Copyright:
© 2023 American Journal of Preventive Medicine
PY - 2023/6
Y1 - 2023/6
N2 - Introduction: Cardiovascular health level according to the American Heart Association's Life's Essential 8 (LE8) in China and its effectiveness on the 10-year and lifetime risk of atherosclerotic cardiovascular diseases is unclear. Methods: This prospective study included 88,665 participants in the China-PAR cohort (data from 1998 to 2020) and 88,995 in the Kailuan cohort (data from 2006 to 2019). Analyses were conducted by November 2022. LE8 was measured according to the American Heart Association's LE8 algorithm, and a high cardiovascular health status was defined as a LE8 score ≥80 points. Participants were followed for the primary composite outcomes, including fatal and nonfatal acute myocardial infarction, ischemic stroke, and hemorrhagic stroke. The lifetime risk was estimated from the cumulative risk of atherosclerotic cardiovascular diseases through ages 20−85 years, the association of LE8 and LE8 change with atherosclerotic cardiovascular diseases was assessed with the Cox proportional-hazards model, and partial population-attributable risks evaluated the proportion of atherosclerotic cardiovascular diseases that could be averted. Results: The mean LE8 score was 70.0 in the China-PAR cohort and 64.6 in the Kailuan cohort, with 23.3% and 8.0% of participants having a high cardiovascular health status, respectively. Participants in the highest quintile had about 60% lower 10-year and lifetime risk of atherosclerotic cardiovascular diseases in the China-PAR and Kailuan cohorts than participants with the lowest quintile LE8 score. If everyone maintained the highest quintile of LE8 score, approximately half of the atherosclerotic cardiovascular diseases could be prevented. The participant with LE8 score that increased from the lowest to the highest tertile during 2006−2012 had a 44% (hazard ratio=0.56; 95% CI=0.45, 0.69) lower observed risk and a 43% (hazard ratio=0.57; 95% CI=0.46, 0.70) lower lifetime risk of atherosclerotic cardiovascular diseases than those remaining in the lowest tertile in the Kailuan cohort. Conclusions: The LE8 score was below optimal levels in Chinese adults. A high baseline LE8 score and an improving LE8 score were associated with decreased 10-year and lifetime risk of atherosclerotic cardiovascular diseases.
AB - Introduction: Cardiovascular health level according to the American Heart Association's Life's Essential 8 (LE8) in China and its effectiveness on the 10-year and lifetime risk of atherosclerotic cardiovascular diseases is unclear. Methods: This prospective study included 88,665 participants in the China-PAR cohort (data from 1998 to 2020) and 88,995 in the Kailuan cohort (data from 2006 to 2019). Analyses were conducted by November 2022. LE8 was measured according to the American Heart Association's LE8 algorithm, and a high cardiovascular health status was defined as a LE8 score ≥80 points. Participants were followed for the primary composite outcomes, including fatal and nonfatal acute myocardial infarction, ischemic stroke, and hemorrhagic stroke. The lifetime risk was estimated from the cumulative risk of atherosclerotic cardiovascular diseases through ages 20−85 years, the association of LE8 and LE8 change with atherosclerotic cardiovascular diseases was assessed with the Cox proportional-hazards model, and partial population-attributable risks evaluated the proportion of atherosclerotic cardiovascular diseases that could be averted. Results: The mean LE8 score was 70.0 in the China-PAR cohort and 64.6 in the Kailuan cohort, with 23.3% and 8.0% of participants having a high cardiovascular health status, respectively. Participants in the highest quintile had about 60% lower 10-year and lifetime risk of atherosclerotic cardiovascular diseases in the China-PAR and Kailuan cohorts than participants with the lowest quintile LE8 score. If everyone maintained the highest quintile of LE8 score, approximately half of the atherosclerotic cardiovascular diseases could be prevented. The participant with LE8 score that increased from the lowest to the highest tertile during 2006−2012 had a 44% (hazard ratio=0.56; 95% CI=0.45, 0.69) lower observed risk and a 43% (hazard ratio=0.57; 95% CI=0.46, 0.70) lower lifetime risk of atherosclerotic cardiovascular diseases than those remaining in the lowest tertile in the Kailuan cohort. Conclusions: The LE8 score was below optimal levels in Chinese adults. A high baseline LE8 score and an improving LE8 score were associated with decreased 10-year and lifetime risk of atherosclerotic cardiovascular diseases.
UR - http://www.scopus.com/inward/record.url?scp=85149898876&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2023.01.009
DO - 10.1016/j.amepre.2023.01.009
M3 - Article
C2 - 36813641
AN - SCOPUS:85149898876
SN - 0749-3797
VL - 64
SP - 927
EP - 935
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 6
ER -
