An opportunity for prevention: associations between the Life's Essential 8 score and cardiovascular incidence using prospective data from UK Biobank.

Petermann-Rocha, F., Deo, S. , Celis-Morales, C. , Ho, F. K., Bahuguna, P. , McAllister, D. , Sattar, N. and Pell, J. P. (2023) An opportunity for prevention: associations between the Life's Essential 8 score and cardiovascular incidence using prospective data from UK Biobank. Current Problems in Cardiology, 48(4), 101540. (doi: 10.1016/j.cpcardiol.2022.101540) (PMID:36528209)

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 (HR : 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.

• Item Type: Articles
• Additional Information: This research has been conducted using the UK Biobank resource under application number 7155. UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Assembly Government and the British Heart Foundation.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Celis, Dr Carlos and Ho, Dr Frederick and McAllister, Professor David and Bahuguna, Dr Pankaj and Pell, Professor Jill and Petermann-Rocha, Mrs Fanny and Sattar, Professor Naveed and Deo, Salil
• Authors: Petermann-Rocha, F., Deo, S., Celis-Morales, C., Ho, F. K., Bahuguna, P., McAllister, D., Sattar, N., and Pell, J. P.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Current Problems in Cardiology
• Publisher: Elsevier
• ISSN: 0146-2806
• ISSN (Online): 1535-6280
• Published Online: 14 December 2022