Association between Life’s essential 8 and mortality among individuals with hypertension

The "Life's Essential 8" (LE8) score is an assessment of cardiovascular health recently introduced by the American Heart Association. This study aimed to explore the correlation of the total LE8 score and its individual metrics with all-cause and cardiovascular disease (CVD) mortality in patients with hypertension. Data from 10,556 hypertension adults were retrieved from National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. After a median follow-up of 6.75 years, patients with high LE8 scores (≥ 75 points) showed significantly lower mortality rates from all causes and CVD (P < 0.001). Cox regression analysis indicated that high LE8 scores were associated with a 40% lower risk of all-cause [0.60(0.50-0.73)] and CVD mortality [0.60(0.43-0.83)] compared to low scores. As the total LE8 score increased linearly, the likelihood of all-cause and CVD mortality decreased, with a potential threshold at 60 points. Subgroup analyses revealed that diet, sleep, nicotine exposure, physical activity, and blood glucose control affected both types of mortality. The LE8 score was negatively correlated with the risks of all-cause and CVD mortality in hypertensive patients. Life interventions and management of physical indicators based on the LE8 score may be an effective way to improve mortality in hypertensive patients.