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Zhong J, Jiang J, Guo L, Liu Y, Wu S, Peng X, Chen S, Qin X, Dong S, Huang R, Zheng W. 10-year trajectory of Life's Essential 8 and incident hypertension: a community-based cohort study. Lipids Health Dis 2024; 23:278. [PMID: 39223616 PMCID: PMC11368014 DOI: 10.1186/s12944-024-02257-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The health effects of Life's Essential 8 (LE8) on chronic diseases have been disclosed, but its association with hypertension remains unknown. The current study aimed to explore the potential link between 10-year LE8 trajectory and the incidence of hypertension. METHODS LE8 was constructed from four behaviors and four metabolic factors, ranging from 0 to 100. Latent mixture models were used to identify trajectories of LE8 scores during 2006 to 2016. Incident hypertension was diagnosed based on self-reported clinical diagnoses and physical examinations from 2016 to 2020. Cox models were employed to assess the association of LE8 trajectories with hypertension. In addition to incorporating the mean hs-CRP levels from 2006 to 2016, age, sex, monthly income, educational level, and occupation at recruitment were adjusted for as confounding factors. RESULTS 7500 participants aged 40.28 ± 10.35 years were included in the study, of whom 2907 (38.76%) were women. Five LE8 trajectory patterns were identified. After around four-year follow-up, 667 hypertension events were observed. Compared to the Low-Stable trajectory, the hazard ratios and 95% confidence intervals for the Moderate-Increasing, Moderate-Decreasing, Moderate-Stable, and High-Stable trajectories were 0.51 (0.40, 0.65), 0.81 (0.64, 1.02), 0.45 (0.36, 0.58), 0.23 (0.16, 0.33), respectively. The risk of incident hypertension decreased as participants improved their LE8 status. The robustness of the primary results was confirmed through several sensitivity analyses. CONCLUSIONS LE8 trajectories were associated with the incident hypertension. People who improved their LE8 scores over time experienced a decreased risk of hypertension, even if they started with lower LE8 scores initially.
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Affiliation(s)
- Jiwen Zhong
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, 51900, Guangdong, China
| | - Jinguo Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China
| | - Liang Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, 430060, Wuchang, Wuhan, China
- Hubei Key Laboratory of Cardiology, 430060, Wuchang, Wuhan, China
| | - Yang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38# Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, No.57 Xinhua East Road, 063000, Tangshan, Hebei Province, China
| | - Xinyi Peng
- Hypertension Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, No.57 Xinhua East Road, 063000, Tangshan, Hebei Province, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38# Xueyuan Road, Haidian District, 100191, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Shaohong Dong
- Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), 518020, Shenzhen, Guangdong, China
| | - Ruijun Huang
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, 51900, Guangdong, China.
| | - Wei Zheng
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, 51900, Guangdong, China.
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Bai Y, Guo S. Association of Life's Essential 8 with depression among adults: A cross-sectional study of NHANES. J Investig Med 2024:10815589241261286. [PMID: 38869164 DOI: 10.1177/10815589241261286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
The prevalence of depression continues to rise, and it has a high death and disability rate. Life's Essential 8 (LE8) is an updated measurement of cardiovascular health (CVH), and a higher score of LE8 represents healthier CVH. Our study aimed to investigate the association between the LE8 and depression among adults. This cross-sectional study used data from the National Health and Nutrition Examination Survey. CVH was measured by using LE8 according to American Heart Association definitions. Depression was assessed by the 9-item Patient Health Questionnaire (PHQ-9). Weighted univariable and multivariable logistic analyses were performed to investigate the association of LE8 with depression. Subgroup analyses were also conducted in different groups based on age, gender, race, body mass index (BMI), smoking, arthritis, cardiovascular disease, and chronic kidney disease. A total of 22,149 participants were included in the database, with a mean LE8 score of 71.27. The prevalence of depression was 7.32%. The mean scores of LE8 in health behaviors and health factors were 73.28 and 69.26, respectively. After adjustment of potential confounders, a higher LE8 score was associated with lower odds of depression (odds ratio = 0.27, 95% confidence interval: 0.20-0.37). A similar association was observed in the subgroup analyses. Higher overall LE8 scores and higher scores for each component (diet, physical activity, nicotine exposure, sleep duration, BMI, blood lipids, blood glucose, and blood pressure) were associated with lower odds of depression. LE8 score might be a useful tool for both cardiologists and psychiatrists in screening for and monitoring physical and mental health. Primary care physicians also could better tailor care and interventions to address both physical and mental health needs.
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Affiliation(s)
- Yinyin Bai
- Department of Psychiatry, Liupanshui Third People's Hospital, Guizhou, P.R. China
| | - Sanqin Guo
- Department of Rehabilitation, Liupanshui Third People's Hospital, Guizhou, P.R. China
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Mai Y, Yan S, Gong L. Cardiovascular health metrics and diabetic nephropathy: a nationally representative cross-sectional study. Int Urol Nephrol 2024:10.1007/s11255-024-04097-3. [PMID: 38839692 DOI: 10.1007/s11255-024-04097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/25/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND The pathogenesis of diabetic nephropathy is well-documented to be multifactorial. However, research available on the association between cardiovascular health and diabetic nephropathy is limited. Thus, this study aimed to investigate these potential associations and provide guidance for disease prevention. METHODS We applied Life's Essential 8 (LE8) identified by the American Heart Association, which integrates multiple health behaviors and health factors to measure cardiovascular health. This study covered 4207 adults with diabetes from the National Health and Nutrition Examination Survey spanning 2007-2018. Weighted regression models assessed the estimated effect of LE8 score on the prevalence of diabetic nephropathy as well as their corresponding clinical indicators. Weighted restricted cubic spline models discussed the possible nonlinear dose-response relationships further. Subgroup analyses clarified the effects of other covariates on correlations. RESULTS After adjusting for all covariates, participants with moderate or high cardiovascular health showed a decreased prevalence of diabetic nephropathy (odds ratio [OR]:0.52; 95% confidence interval [CI]:0.42-0.63), and also a decrease in the urinary albumin-to-creatinine ratio [UACR] (β: - 0.83; 95% CI:- 1.00 to - 0.65). The prevalence of diabetic nephropathy and the level of UACR tended to decrease linearly as the total LE8 score increased (P for nonlinear > 0.05). Subgroup analyses showed that the effects of increased overall LE8 score and the specific cardiovascular health construct varied across age and obesity strata. CONCLUSION Elevated overall LE8 score was significantly associated with a lower prevalence of diabetic nephropathy in U.S. adults, and the effects of the specific cardiovascular health construct on diabetic nephropathy and their corresponding clinical indicators varied. In all, maintaining good cardiovascular health by refining LE8 metrics may help reduce the adverse effects.
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Affiliation(s)
- Yanpei Mai
- School of Medicine, South China University of Technology, Guangzhou, 510006, China.
| | - Si Yan
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Liya Gong
- Department of Imaging Diagnostics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
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Jiang J, Ning N, Liu Y, Cai Z, Zhao M, Peng X, Li L, Chen S, Wang J, Wang F, Qin X, Ma Y, Wu S. Association of Life's Essential 8 with all-cause mortality and risk of cancer: a prospective cohort study. BMC Public Health 2024; 24:1406. [PMID: 38802806 PMCID: PMC11129373 DOI: 10.1186/s12889-024-18879-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND No study has concentrated on the association of LE8 with cancer risk and death. We aim to examine the association of LE8 with death and cancer. METHODS A total of 94733 adults aged 51.42 ± 12.46 years and 77551 participants aged 54.09±12.06 years were enrolled in longitudinal and trajectory analysis respectively. Baseline LE8 was divided into three groups based on the American Heart Association criteria and three trajectory patterns by latent mixture models. We reviewed medical records and clinical examinations to confirm incident cancer during the period from 2006 to 2020. Death information was collected from provincial vital statistics offices. Cox models were used. RESULTS 12807 all-cause deaths and 5060 cancers were documented during a 14-year follow-up. Relative to participants with high LE8 at baseline, participants with lower levels of LE8 have a significantly increased risk of mortality and incident cancer. All these risks have an increasing trend with LE8 level decreasing. Meanwhile, the trajectory analysis recorded 7483 all-cause deaths and 3037 incident cancers after approximately 10 years. The associations of LE8 with death and cancer were identical to the longitudinal study. In the subtype cancer analysis, LE8 has a strong effect on colorectal cancer risk. Moreover, the cut point is 56.67 in the association between LE8 and death, while the cut point altered to 64.79 in the association between LE8 and incident cancers. These associations were enhanced among younger adults. CONCLUSIONS There was a significant association of LE8 with death and cancer risk, especially for the young population.
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Affiliation(s)
- Jinguo Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Heping District, Shenyang, Liaoning Province, 110004, China
| | - Ning Ning
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Yang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38# Xueyuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Zhiwei Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Maoxiang Zhao
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xinyi Peng
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Liuxin Li
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, No.57 Xinhua East Road, Tangshan, 063000, Hebei Province, China
| | - Jing Wang
- Peking University Medical Informatics Center, Peking University, Beijing, China
| | - Feng Wang
- Chinese Center for Health Education, Beijing, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38# Xueyuan Road, Haidian District, Beijing, 100191, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China.
| | - Yanan Ma
- Department of Epidemiology and Biostatistics, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, No.57 Xinhua East Road, Tangshan, 063000, Hebei Province, China.
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Tang Y, Dong W, Shen J, Jiang G, Wang Q, Hao J, Hu Z. Life's Essential 8 and osteoporosis in adults aged 50 years or older: data from the National Health and Nutrition Examination Survey. Arch Osteoporos 2024; 19:13. [PMID: 38363413 DOI: 10.1007/s11657-024-01368-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024]
Abstract
In this cross-sectional study, we examined the association between Life's Essential 8 (LE8) and bone mineral density (BMD) as well as osteoporosis risk among adults aged 50 and over. The findings of this study revealed that higher LE8 scores were associated with higher BMD and reduced osteoporosis risk. PURPOSE The objective of the present study was to evaluate the association between Life's Essential 8 (LE8) and bone mineral density (BMD), as well as osteoporosis risk, in adults aged 50 years or over. METHODS This cross-sectional study recruited individuals who were 50 years old or older from the National Health and Nutrition Examination Survey. LE8 scores were evaluated and calculated according to the scoring algorithm based on the American Heart Association recommendations, which were further categorized into health behaviors (LE8-HB) and health factors (LE8-HF) scores. Furthermore, the present study utilized multivariate linear regression models to examine the correlations between BMD and LE8 scores. In addition, ordinal logistic regression models were employed to determine the associations between the risk of osteoporosis (normal BMD, osteopenia, and osteoporosis) and LE8 scores. RESULTS The final analysis included a total of 2910 participants, whose mean age was 64.49 ± 9.28 years. LE8 and LE8-HF scores exhibited a negative association with BMD and a positive association with osteoporosis risk in unadjusted models. Nevertheless, after adjustment for covariates, LE8 and LE8-HB scores exhibited a positive association with BMD and a negative association with osteoporosis risk, regardless of age, sex, or menopausal status. CONCLUSIONS Scoring systems based on multiple lifestyle and behavior factors, similar to LE8, have the potential to become a novel option and be used for osteoporosis risk assessment.
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Affiliation(s)
- Yuchen Tang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Dong
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Spinal Surgery, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Jieliang Shen
- Department of Rehabilitation Medicine, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, China
| | - Guanyin Jiang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Qiufu Wang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Hao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Zhenming Hu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Chongqing, China.
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