An Opportunity for Prevention: Associations Between the Life's Essential 8 Score and Cardiovascular Incidence Using Prospective Data from UK Biobank |
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| Institution: | 1. BHF Cardiovascular Research Centre. School of Cardiovascular and Metabolic Health, University of Glasgow. Glasgow, UK;2. Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile;3. School of Health and Wellbeing, University of Glasgow. Glasgow, UK;4. Louis Stokes Cleveland VA Medical Center, Cleveland USA;5. Department of Surgery, Case School of Medicine, Case Western Reserve University, Cleveland USA;6. Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile;7. Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow Glasgow, UK;1. Cardiovascular Internal Medicine Department, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China;2. Queen Mary School, Nanchang University, Nanchang, Jiangxi, China;3. Undergraduate clinical medicine department of Tongji Medical college of Huazhong universiity of science and technology, Wuhan, Hubei, China;4. Department of cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;1. Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Professional Performance and Compassionate Care Research Group, Amsterdam, the Netherlands;2. Amsterdam Public Health Research Institute, Amsterdam, the Netherlands;3. Centre for Healthcare Innovation Research, Department of Health Services Research & Management, City University of London, London, UK;4. Netherlands Society of Cardiology, Utrecht, the Netherlands;5. University Medical Center Utrecht, Department of Cardiology, Utrecht, the Netherlands;6. Amsterdam UMC, University of Amsterdam, Department of Cardiology, Amsterdam, the Netherlands;1. Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH;2. Houston Methodist Hospital and Weill Cornell Medicine, Houston, TX;3. Louis Stokes VA Medical Center, Cleveland, OH |
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| Abstract: | To investigate the association between the Life's Essential 8 (LE8) score and the incidence of four cardiovascular outcomes (ischemic heart disease, myocardial infarction, stroke, and heart failure HF]) – separately and as a composite outcome of major adverse cardiovascular events (MACE) – in UK Biobank.250,825 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet, and sleep were used to create a modified version of the LE8 score. Associations between the score (both as a continuous score and as quartiles) and outcomes were investigated using adjusted Cox proportional hazard models. The potential impact fractions of two scenarios were also calculated. Over a median follow-up of 10.4 years, there were 25,068 MACE. Compared to individuals in the highest quartile of the score (healthiest), those in the lowest quartile (least healthy) had 2.07 (95% CI: 1.99; 2.16) higher risk for MACE. The highest relative risk gradient of the individual outcomes was observed for HF (HRlowest quartile: 2.67 95% CI: 2.42; 2.94]). The magnitude of association was stronger in participants below 50 years, women, and ethnic minorities. A targeted intervention that increased, by 10-points, the score among individuals in the lowest quartile could have prevented 9.2% of MACE. Individuals with a lower LE8 score experienced more MACE, driven especially by incident HF. Our scenarios suggested that relevant interventions targeted towards those in the lowest quartile may have a greater impact than interventions producing small equal changes across all quartiles. |
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