Association of cardiovascular health with morbidity and mortality among U.S. adults with osteoarthritis: a population-based study

BACKGROUND: Osteoarthritis (OA) is recognized as the most common joint disease with serious public health implications. Cardiovascular health (CVH) is also an issue that is frequently emphasized in public health and has an impact on a variety of diseases and mortality rates. This study aims to investigate the association of CVH with the morbidity of OA. And explore the association of CVH with both all-cause and cardiovascular disease (CVD) mortality among US adults with OA. METHODS: This study utilized data from the National Health and Nutrition Examination Survey 2005-2018, which included 21,289 adults aged ≥ 20, representing 137,912,968 Americans. CVH was assessed by Life's Essential 8 (LE8) includes 4 behavior and 4 factor metrics. Total LE8 scores were calculated from the unweighted average on a 0-100 scale and were categorized as high (80-100), moderate (50-79), and low (0-49) CVH. Multivariable logistic regression explored the association of OA with CVH. Cox proportional hazards regression examined LE8 associations with mortality. RESULTS: Adjusting for confounding variables, per 10 points LE8 increase, the OR was 0.82 in association with OA, while OA morbidity were decreased by 30% (OR 0.70, 95%CI 0.57, 0.87) and 54% (OR 0.46, 95%CI 0.36, 0.60) in moderate and high CVH compared to low CVH. During a median follow-up of 7.58 years in OA participants, per 10 points LE8 increase were decreased 23% mortality of all-cause (HR 0.77, 95%CI 0.70, 0.85) and 29% mortality of CVD (HR 0.71, 95% 0.60, 0.84). Moderate and high CVH demonstrated a decreased mortality of both all-cause and CVD compared with low CVH. CONCLUSIONS: Higher CVH is associated with a lower morbidity of OA and lower mortality in OA participants. Our results suggest that adherence to CVH could reduce the morbidity of OA and improve survival outcomes for those affected.