Dual‐trajectories of Systolic Blood Pressure and Modified Life's Essential 8 With Gastrointestinal Cancer and All‐Cause Mortality: A Prospective Cohort Study

ABSTRACT This study aimed to describe joint longitudinal patterns of SBP and modified Life's Essential 8 (LE8) and to further investigate their associations with risks of gastrointestinal cancer and all‐cause mortality in the Kailuan Study. Since systolic blood pressure (SBP) was used to assess the dual‐trajectories, modified LE8 score was calculated as the average of 7 component score after excluding blood pressure. A group‐based dual‐trajectories model was used to characterize joint longitudinal patterns of SBP and modified LE8 using data from 2006/2007 to 2014/2015 survey. Multivariable Cox proportional hazards regression models were used to assess associations of dual‐trajectories patterns with risks of gastrointestinal cancer and all‐cause mortality (hazard ratio, HR and 95% confidence interval, 95% CI). A total of 48,596 participants were included in the current analysis, and five dual‐trajectories groups were identified. Compared with group 3, group 2 had the highest risk of gastrointestinal cancer (HR, 1.64; 95% CI, 1.17–2.29), followed by group 4 and group 5, whereas group 1 had the lowest risk of gastrointestinal cancer (HR, 1.09; 95% CI, 0.78–1.51). Similar results were observed for associations between dual‐trajectories of SBP and modified LE8 and all‐cause mortality. This study found joint longitudinal patterns of SBP and modified LE8 and revealed their associations with the risks of gastrointestinal cancer and all‐cause mortality. The findings suggest that individuals with lower modified LE8 scores had higher risks of gastrointestinal cancer and all‐cause mortality even at similar SBP levels, underscoring the importance of comprehensive cardiovascular health for risk stratification and prevention.