Baseline and longitudinal cardiovascular health using Life’s Essential 8 metrics with the risk of incident hypertension

ABSTRACT

Objective

The quantification of cardiovascular health (CVH) was updated by the American Heart Association recently by using the “Life’s Essential 8” (LE8) score. We aimed to investigate the associations of baseline and longitudinal CVH status measured by the new LE8 score (except for blood pressure) with the risk of hypertension.

Methods

A total of 52 990 participants with complete data on LE8 metrics and without hypertension were enrolled from the Kailuan study, Tangshan, China. The associations of incident hypertension with the overall baseline, time-updated, and time-varying CVH score (ranging 0 [lowest] to 100 [highest]), and each component of LE8, were assessed by Cox regressions.

Results

During a median follow-up of 10.73 years 28 380 cases of incident hypertension were identified. The risk of hypertension attenuated with increased CVH score (P_trend < 0.0001), the hazard ratios (HRs) in high CVH versus low CVH group was 0.54 (95% confidence interval [CI], 0.51–0.57) for baseline CVH, 0.47 (95% CI, 0.45–0.50) for time-updated CVH, and 0.59 (95% CI, 0.55–0.63) for time-varying CVH. The predictive value of CVH in predicting hypertension improved by using LE8 than using Life’s Simple 7 metrics. Among LE8 components, body mass index score was the strongest risk factor for hypertension. Subgroup analyses showed that the benefit of a higher CVH score on hypertension was more prominent in young adults and in women (P_interaction < 0.05).

Conclusions

A higher CVH score assessed by new LE8 is associated with a lower risk of subsequent hypertension, especially young adults and women.

KEYWORDS:

• Life’s Essential 8
• cardiovascular health
• hypertension
• longitudinal association
• cohort study

Acknowledgments

We thank all study participants, their relatives, the members of the survey teams at the 11 regional hospitals of the Kailuan Medical Group, and the project development and management teams at the Beijing Tiantan Hospital and the Kailuan Group.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Shouling Wu and Anxin Wang designed the study and interpreted the data. Xue Tian drafted the manuscript, performed statistical analyses, and interpreted the data. Shuohua Chen, Yijun Zhang, Xiaoli Zhang, Qin Xu, and Penglian Wang revised the manuscript and interpreted the data. All authors read and approved the final manuscript.

Data availability statement

The data generated by our research could be made available upon request to the corresponding authors ([email protected]).

Ethical statement

The study was performed according to the guidelines of the Helsinki Declaration and was approved by the Ethics Committee of Kailuan General Hospital (approval number: 2006–05) and Beijing Tiantan Hospital (approval number: 2010-014-01). All participants agreed to take part in the study and provided informed written consent.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10641963.2023.2271190

Additional information

Funding

This work was supported by the National Key Research and Development Program of China (2022YFC3600600 and 2022YFC2502400), Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University (CCMU2022ZKYXZ009), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), Fund for Young Talents of Beijing Medical Management Center (QML20230505), the high-level public health talents (xuekegugan-02-47) and the Fellowship from the China Postdoctoral Science Foundation (2023M732408)