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Table 3 Adjusted hazard ratios of Life’s Essential 8 cardiovascular health (CVH) score with risk of cardiovascular disease mortality, NHANES 2005–2018

From: Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study

CVH components

CVH score, HR (95% CI)

P for trendc

PAF

0–49

50–74

75–100

Score ≥ 75 vs. < 75 points

Score ≥ 85 vs. < 85 points

Total

 Cases/participants

209/4810

250/11,257

39/3884

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.50 (0.37–0.66)

0.24 (0.15–0.40)

 < 0.001

  

 Fully adjusteda

1.00 (reference)

0.62 (0.46–0.83)

0.36 (0.21–0.59)

 < 0.001

42.9

70.6

Diet

 Cases/participants

245/8761

132/5426

121/5764

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.77 (0.56–1.05)

0.64 (0.46–0.89)

0.007

  

 Fully adjustedb

1.00 (reference)

0.87 (0.63–1.22)

0.87 (0.59–1.27)

0.449

5.9

5.0

Physical activity

 Cases/participants

359/11,133

22/1008

117/7810

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

1.05 (0.57–1.93)

0.52 (0.39–0.70)

 < 0.001

  

 Fully adjustedb

1.00 (reference)

1.40 (0.79–2.49)

0.74 (0.53–1.03)

0.103

17.8

15.2

Nicotine exposure

 Cases/participants

155/5213

23/691

320/14,047

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.76 (0.38–1.53)

0.57 (0.43–0.77)

 < 0.001

  

 Fully adjustedb

1.00 (reference)

0.87 (0.42–1.79)

0.78 (0.55–1.09)

0.102

7.1

8.8

Sleep health

 Cases/participants

111/3508

114/4420

273/12,023

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.80 (0.56–1.15)

0.71 (0.52–0.98)

0.047

  

 Fully adjustedb

1.00 (reference)

1.07 (0.74–1.54)

0.98 (0.71–1.34)

0.750

2.2

2.2

Body mass index

 Cases/participants

231/8422

166/6681

101/4848

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.57 (0.42–0.76)

0.56 (0.40–0.79)

 < 0.001

  

 Fully adjustedb

1.00 (reference)

0.72 (0.53–0.99)

0.75 (0.52–1.09)

0.067

9.7

9.7

Blood lipids (non-HDL cholesterol)

 Cases/participants

193/7557

85/4697

220/7697

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.90 (0.62–1.30)

0.96 (0.72–1.28)

0.836

  

 Fully adjustedb

1.00 (reference)

1.06 (0.73–1.54)

0.92 (0.69–1.22)

0.506

6.5

3.3

Blood glucose

 Cases/participants

186/3660

178/7811

134/8480

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.52 (0.38–0.70)

0.41 (0.29–0.57)

 < 0.001

  

 Fully adjustedb

1.00 (reference)

0.68 (0.48–0.95)

0.63 (0.44–0.89)

0.031

10.3

10.2

Blood pressure

 Cases/participants

235/5583

100/4051

163/10,317

   

 Age-, sex-, and race/ethnicity-adjusted

1.00 (reference)

0.80 (0.57–1.13)

0.63 (0.46–0.87)

0.006

  

 Fully adjustedb

1.00 (reference)

0.94 (0.67–1.32)

0.74 (0.54–1.01)

0.047

12.5

16.2

  1. CVH cardiovascular health, CI confidence interval, HR hazard ratio, NA not available, PAF population-attributable fraction
  2. aAdjusted for sex, age, race/ethnicity, education level, marital status, ratio of family income poverty, and history of heart disease and stroke
  3. bAdjusted for sex, age, race/ethnicity, education level, marital status, ratio of family income poverty, history of heart disease and stroke, diet, nicotine exposure, physical activity, sleep health, body mass index, blood glucose, blood lipids, and blood pressure. When the association between each CVH metric and mortality was evaluated, this metric was excluded from the adjustment
  4. cTests for linear trends across three categories of cardiovascular health metrics scores were performed by modeling the median value within each category as a continuous variable
  5. dThe individual PAFs were not calculated since the individual cardiovascular health metrics with adjusted HRs were ≥ 1.0
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BMC Medicine

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