Key result
A poor Life's Essential 8 score was associated with a 78% higher risk of incident atrial fibrillation compared to an ideal score (sHR 1.78) over a median 10-year follow-up.
Why the study?
Atrial fibrillation burden can be reduced by targeting modifiable risk factors, but limited data exist on the association between the AHA's Life's Essential 8 score and AF incidence.
Does a higher Life's Essential 8 score reduce the incidence of atrial fibrillation in adults aged ≥45 years?
Cohort (n=3,161)
No
Does a higher Life's Essential 8 score reduce the incidence of atrial fibrillation in adults aged ≥45 years?
Answers are grounded in this paper and cite their sources.
Higher adherence to the American Heart Association's Life's Essential 8 cardiovascular health metrics is associated with a significantly lower risk of developing incident atrial fibrillation.
Background Atrial fibrillation (AF) burden can be reduced by targeting modifiable risk factors. Limited data exist on the association between American Heart Association’s Life’s Essential 8 (LE8) score (higher scores healthier) and AF incidence. Methods We studied AF-free Framingham Heart Study Offspring and Omni 1 participants aged ≥45 years who attended ≥1 index exam in which LE8 components were assessed. LE8 scores were calculated incorporating body mass index, blood pressure, non-HDL cholesterol, glucose, smoking, physical activity, diet, and sleep. Fine-Gray hazards models, accounting for the competing risk of death, were used to calculate subdistribution hazards ratios (sHR) for the association of LE8 score and its components with 10-year AF incidence. Results We included 3,161 unique participants (n=4,628 index exams, 57% women, mean age 65±9 years). Participants were classified as having “ideal” (LE8≥80; 16% [n=763 exam cycles]), “intermediate” (LE8 50-79; 76% [n=3,519]), or “poor”(LE8<50; 7% [n=346]) cardiovascular health. There were 410 incident AF events (10.4/1,000 person-years). Compared with “ideal”, a “poor” LE8 score was associated with higher AF risk (sHR,1.78; 95%CI, 1.20-2.64; p=0.004); we did not observe a statistically significant association comparing participants with “intermediate” LE8 scores to those with “low” LE8 scores with regards to AF risk. Higher LE8 scores (healthier; continuous) were associated with lower AF risk (sHR per 1-SD increase increment of LE8 score, 0.80; 95%CI, 0.72-0.90; p<0.0001). Conclusions Lower LE8 scores were associated with greater risk of developing AF. Future studies of the role of LE8 in reducing AF burden in the overall population are warranted.
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Daniels et al. (2025) conducted a cohort in Atrial fibrillation (n=3,161). Poor Life's Essential 8 (LE8) score vs. Ideal LE8 score was evaluated on Incident atrial fibrillation (sHR 1.78, 95% CI 1.20-2.64, p=0.004). A poor Life's Essential 8 score was associated with a 78% higher risk of incident atrial fibrillation compared to an ideal score (sHR 1.78) over a median 10-year follow-up.
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