Key result
Maintaining or improving CVH linked to lower CVD risk and longer lifespan in older adults.
Why the study?
Maintaining cardiovascular health is essential for preventing cardiovascular disease, but associations of changes in cardiovascular health over time with CVD and mortality were not fully evaluated.
Does maintaining or improving cardiovascular health (assessed by Life's Essential 8) reduce incident CVD and all-cause mortality in older adults?
Cohort (n=3,364)
Does maintaining or improving cardiovascular health (assessed by Life's Essential 8) reduce incident CVD and all-cause mortality in older adults?
Maintaining high cardiovascular health or improving it over time is significantly associated with lower incident CVD risk and longer lifespan in older adults.
Answers are grounded in this paper and cite their sources.
May support CVH monitoring in older adults; extends prior data but leaves open causal effects.
BACKGROUND: Maintaining cardiovascular health (CVH) is essential for preventing cardiovascular disease (CVD). OBJECTIVES: We aimed to evaluate associations of changes in CVH with CVD and mortality. METHODS: We assessed CVH using Life's Essential 8 (LE8) in 3,364 participants from Framingham Heart Study Offspring cohort. Trajectory analysis was performed to identify LE8 changing patterns from young adulthood to middle age. We also quantified LE8 changes during the late middle and early older adulthood. Cox models were used to evaluate associations with incident CVD and all-cause mortality. RESULTS: Four CVH trajectory groups were identified during a follow-up of 20 years, extending to age 60 years: stable low (11%), improved (17%), rapid decline (9%), and stable high (63%). Compared to stable low group, improved and stable high groups had lower CVD (HR: 0.52; P = 2.55e-7; HR: 0.69; P = 0.002, respectively) and mortality risk (HR: 0.67; P = 7.05e-5; HR: 0.81; P = 0.03, respectively) after age 60 years. Although CVD risk was similar between rapid-decline and stable-low groups (HR: 1.13; P = 0.5), rapid-decline group had higher mortality (HR: 1.51; P = 0.007). In the joint analysis with CVD polygenic risk scores, individuals with low or high polygenic risk score had similar CVD risk in each LE8 trajectory groups. Furthermore, LE8 improvement over 12-year follow-up (starting at ages 60-65 years) was associated with a lower incident CVD risk and all-cause mortality. CONCLUSIONS: Maintaining a high CVH or improving CVH over time was associated with lower CVD risk and longer lifespan.
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Li et al. (2025) conducted a cohort in Cardiovascular disease (n=3,364). Improved cardiovascular health trajectory vs. Stable low cardiovascular health trajectory was evaluated on Incident cardiovascular disease (HR 0.52, p=2.55e-7). Compared to a stable low trajectory, an improved cardiovascular health trajectory was associated with a lower risk of incident cardiovascular disease (HR 0.52; P=2.55e-7) after age 60 years.
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