Life’s Essential 8 and All-Cause and Cardiovascular Disease Mortality Among Korean Adults

BACKGROUND: This study examined the association between Life's Essential 8 (LE8) and the Korean population's risk of all-cause and cardiovascular disease (CVD) mortality. METHODS AND RESULTS: This study included 21,482 adults aged ≥19 years who were enrolled in the Korea National Health and Nutrition Examination Survey. Cardiovascular health (CVH) was assessed using the LE8 score, which comprises the following 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. The LE8 score ranges from 0 to 100 and was categorized as low (0-49), middle (50-79), high (≥80), with higher scores indicating better CVH. A Cox proportional hazards model was used to estimate hazard ratios, and the population attributable fraction (PAF) was used to determine individual risks associated with each CVH metric. During a median follow-up of 6.3 years, there were 709 all-cause and 122 CVD-related deaths. In the fully adjusted model, compared with low scores, middle and high LE8 scores were associated with 34% and 42% lower risks of all-cause mortality, respectively. A similar reduction in CVD mortality was observed with higher LE8 scores. Physical activity showed the highest PAF, contributing 37% for all-cause mortality and 51% for CVD mortality. CONCLUSIONS: Higher LE8 scores were significantly associated with lower all-cause and CVD mortality. Physical activity had the greatest impact on PAF for mortality.