What does this research mean for the field?

Higher cardiovascular health scores measured by the American Heart Association's Life's Essential 8 are associated with significantly lower all-cause and cardiovascular disease mortality in adults both with and without cancer. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 4, 2025BMC CancerOpen Access

Association of the American heart association’s new “life’s essential 8" cardiovascular health with all-cause and cardiovascular mortality in adults with and without cancer: a retrospective cohort study

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Why the study?

Following the AHA's release of the updated Life's Essential 8 score to assess cardiovascular health, the study aimed to quantify its association with all-cause and cardiovascular mortality in adults with and without cancer.

Does a higher Life's Essential 8 (LE8) cardiovascular health score reduce all-cause and cardiovascular mortality in adults with and without cancer?

Structured PICO

Does a higher Life's Essential 8 (LE8) cardiovascular health score reduce all-cause and cardiovascular mortality in adults with and without cancer?

Population

29,352 adults aged 20 to 79 years from the National Health and Nutrition Examination Survey (NHANES) 2005-2018, with and without cancer. Exclusions: pregnant women, minors, missing mortality records.

Intervention

Moderate (50 ≤ LE8 < 80) or High (LE8 ≥ 80) cardiovascular health scores as estimated by the Life's Essential 8 (LE8) algorithm

Comparator

Low cardiovascular health score (LE8 < 50)

Outcome

All-cause mortality and cardiovascular disease (CVD) mortality at median 7.58 years follow-uphard clinical

Higher cardiovascular health scores, as measured by the Life's Essential 8, are significantly associated with reduced all-cause and cardiovascular mortality in adults regardless of cancer status.

Implication

Supports CVH promotion to lower mortality in adults without cancer; leaves open effects in cancer survivors.

Abstract

BACKGROUND: The American Heart Association released an updated algorithm used to assess cardiovascular health (CVH)-the Life's Essential 8 (LE8) score. Our objective was to quantify the association between CVH levels estimated by the LE8 score and all-cause and cardiovascular mortality in adults with and without cancer. METHODS: In this retrospective cohort study, 29,352 adults were included from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 at baseline linked to the 2019 National Death Index records. Cox regression models and Restricted cubic spline were used to evaluate the associations between CVH with cardiovascular mortality and all-cause mortality. RESULTS: In this study, 14.8% of adults achieved a high total CVH score, compared to 20.3% with low scores. The adjusted HR (95% CI) for all-cause mortality in adults without cancer with a moderate or high CVH total scores compared with low scores was 0.71 (0.64, 0.79) and 0.46 (0.35, 0.60), respectively. The corresponding adjusted HR (95% CI) for cardiovascular disease (CVD) mortality was 0.58 (0.47, 0.72) and 0.30 (0.16, 0.57), respectively. And all 8 CVH indicators in CVD mortality were protective factors. The adjusted HRs (95% CI) for all-cause mortality in adults with cancer with moderate or high scores were 0.73 (0.58, 0.92) and 0.75 (0.48, 1.18), respectively. CONCLUSION: According to the new LE8, higher CVH scores were associated with a reduced risk of all-cause and CVD-specific mortality in adults with and without cancer.