Key result
High cardiovascular health and low CRP were associated with reduced all-cause mortality compared to low cardiovascular health and high CRP (HR 0.30; 95% CI 0.18-0.48).
Why the study?
To evaluate the independent, mediating, interactive, and associated effects of C-reactive protein and Life's Essential 8 on all-cause and cardiovascular mortality.
Does high cardiovascular health (LE8) and low CRP reduce all-cause and cardiovascular mortality in American adults?
Cohort (n=10,043)
Does high cardiovascular health (LE8) and low CRP reduce all-cause and cardiovascular mortality in American adults?
Hazard Ratio: 0.3 (95% CI 0.18–0.48)
High cardiovascular health and low CRP levels are associated with significantly reduced risks of all-cause and cardiovascular mortality, with CRP mediating a portion of the mortality risk associated with cardiovascular health.
Supports CV health and CRP for mortality risk stratification; leaves open whether joint targeting improves outcomes.
To evaluate the independent, mediating, interactive, and associated effects of C-reactive protein (CRP) and Life's Essential 8 (LE8) on all-cause and cardiovascular mortality. Utilizing data from 10,043 participants in the NHANES 2005–2010, we employed Cox proportional hazards regression models and causal mediation analysis to investigate the joint and interactive effects of Life's Essential 8 (LE8) and C-reactive protein (CRP) on mortality risk. During an average follow-up of 137.10 months, there were 1591 all-cause deaths and 485 cardiovascular deaths. Weighted linear regression showed that for patients with low cardiovascular health (CVH), the adjusted β was −0.22 (95 % CI: −0.27 to −0.17) for moderate cardiovascular health (CVH) and -0.36 (95 % CI: −0.43 to −0.30) for high cardiovascular health (CVH). Mediation analysis revealed that C-reactive protein (CRP) mediated 10.43 % of all-cause mortality and 9.20 % of cardiovascular mortality for moderate cardiovascular health (CVH) compared to low cardiovascular health (CVH), and 9.95 % and 8.32 % respectively for high cardiovascular health (CVH) compared to low cardiovascular health (CVH). No significant multiplicative or additive interactions between Life's Essential 8 (LE8) and C-reactive protein (CRP) were found in all-cause mortality or cardiovascular mortality. Individuals with high cardiovascular health (CVH) and the first quartile of C-reactive protein (CRP) had HRs of 0.30 (95 % CI 0.18–0.48) for all-cause mortality and 0.31 (95 % CI 0.13–0.74) for cardiovascular mortality compared to those with low cardiovascular health (CVH) and the fourth quartile of C-reactive protein (CRP). These findings suggest that CRP could significantly influence the relationship between cardiovascular health (CVH) and mortality. Interventions that target both lifestyle factors and CRP levels may improve cardiovascular health and potentially lower mortality risks. • This study explores the mediating role of C-reactive protein (CRP) in the relationship between Life's Essential 8 (LE8) and mortality. • Utilizing data from the NHANES 2005-2010 cohort, the study involves a large sample of 100,43 participants, providing robust statistical power. • High LE8 scores are associated with reduced risks of all-cause and cardiovascular mortality, with CRP mediating 8.32% to 10.43%. • Individuals with low cardiovascular health (CVH) and high CRP face the highest mortality risks. • The findings highlight the role of inflammation in the pathway between CVH and mortality, suggesting that targeted interventions could enhance public health.
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Li et al. (2024) reported a cohort. High cardiovascular health (CVH) and first quartile of C-reactive protein (CRP) vs. Low cardiovascular health (CVH) and fourth quartile of C-reactive protein (CRP) was evaluated on all-cause mortality (HR 0.30, 95% CI 0.18-0.48). High cardiovascular health and low CRP were associated with reduced all-cause mortality compared to low cardiovascular health and high CRP (HR 0.30; 95% CI 0.18-0.48).
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