A high Comprehensive Health Assessment Score was associated with lower all-cause mortality (HR 0.45; 95% CI 0.38-0.53) compared to a low score in adults with coronary heart disease.
Cohort (n=4,823)
Yes
Does a higher Comprehensive Health Assessment Score (CHAS) reduce all-cause and cardiac mortality in adults with coronary heart disease?
A higher Comprehensive Health Assessment Score, reflecting better lifestyle, physical function, metabolic health, and comorbidity control, is strongly associated with reduced long-term all-cause and cardiac mortality in patients with coronary heart disease.
Hazard Ratio: 0.45 (95% CI 0.38–0.53)
p-value: p=<0.001
ABSTRACT Background Coronary heart disease (CHD) confers a substantial global burden, and comprehensive health assessment is critical for secondary prevention. However, the independent and joint associations of multidimensional health with long‐term mortality in CHD patients remain unclear in population‐based studies. Methods This prospective cohort study included 4823 U.S. adults with self‐reported CHD using linked data from the National Health and Nutrition Examination Survey 1999–2018 and National Center for Health Statistics mortality files (through 2019). Associations were evaluated using Cox proportional hazards and Fine–Gray competing risk models, with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated. Results Over a median follow‐up of 6.2 years (IQR: 3.5–9.1), 1542 deaths occurred, including 587 cardiac deaths. After full adjustment, compared with low Comprehensive Health Assessment Score (CHAS reference), moderate CHAS was associated with lower all‐cause mortality (HR = 0.68; 95% CI: 0.59–0.78) and cardiac mortality (HR = 0.62; 95% CI: 0.51–0.76); High CHAS showed further risk reductions (all‐cause mortality: HR = 0.45; 95% CI: 0.38–0.53; cardiac mortality: HR = 0.39; 95% CI: 0.30–0.51). Dose–response relationships were observed (P for trend < 0.001). Physical activity (≥ 150 MET‐min/week) (all‐cause mortality: HR = 0.71; 95% CI: 0.63–0.80) and statin use (cardiac mortality: HR = 0.58; 95% CI: 0.49–0.69) were the strongest independent predictors. Subgroup analyses showed consistent associations across age, sex, and obesity. Conclusions A favorable lifestyle, physical function, metabolic health, and comorbidity control, was strongly associated with lower cardiac and all‐cause mortality in patients with CHD, supporting multidimensional health management for secondary prevention of CHD.
Li et al. (Mon,) conducted a cohort in Coronary heart disease (n=4,823). High Comprehensive Health Assessment Score (CHAS) vs. Low Comprehensive Health Assessment Score was evaluated on All-cause mortality (HR 0.45, 95% CI 0.38-0.53, p=<0.001). A high Comprehensive Health Assessment Score was associated with lower all-cause mortality (HR 0.45; 95% CI 0.38-0.53) compared to a low score in adults with coronary heart disease.