News | AHA | April 18, 2023

Research on Cardiovascular Health and Longevity Focuses on AHA Life’s Essential 8 (LE8) Components

Researchers who studied the impact of adherence to key health metrics on longevity have published findings that reinforce the value of lifestyle behaviors and health factors. The study, “Cardiovascular Health and Life Expectancy Among Adults in the United States,” was published April 10 in the American Heart Association (AHA) journal Circulation.

Researchers who studied the impact of adherence to key health metrics on longevity have published findings that reinforce the value of lifestyle behaviors and health factors, focusing on the American Heart Association updated algorithm for evaluating cardiovascular health (CVH) — Life’s Essential 8 (LE8) score. The study, “Cardiovascular Health and Life Expectancy Among Adults in the United States,” was published April 10 in the American Heart Association (AHA) journal Circulation. Image credit: AHA


April 18, 2023 — Researchers who studied the impact of adherence to key health metrics on longevity have published findings that reinforce the value of lifestyle behaviors and health factors. The study, “Cardiovascular Health and Life Expectancy Among Adults in the United States,” was published April 10 in the American Heart Association (AHA) journal Circulation.

Highlighting the American Heart Association updated algorithm for evaluating cardiovascular health (CVH) — AHA's Life’s Essential 8 (LE8) score, researchers aimed to quantify the associations of CVH levels, estimated by the LE8 score, with life expectancy in a nationally representative sample of US adults.

Results led authors to conclude that adhering to a high CVH, defined as the LE8 score, is related to a considerably increased life expectancy in US adults. Their research found that people with higher scores for cardiovascular health lived up to nine years longer on average than those with the lowest scores. 

Updated by the American Heart Association in June, 2022, “Life’s Essential 8” includes the eight components of cardiovascular health: healthy diet, participation in physical activity, avoidance of nicotine, healthy sleep, healthy weight, and healthy levels of blood lipids, blood glucose, and blood pressure.

The study was conducted by a group of researchers led by Hao Ma, PhD, and Xuan Wang, PhD, both from the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, who contributed equally. They were joined by the following departmental colleagues: Qiaochu Xue, Xiang Li, Yoriko Helanza, and Lu Qi, along with: Zhaoxia Liang, Obstetrical Department, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China; and Oscar H. Franco, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands.

Researchers included 23,003 non-pregnant, non-institutionalized participants aged 20 to 79 years who participated in the National Health and Nutrition Examination Survey from 2005 to 2018, and whose mortality was identified through linkage to the National Death Index through December 31, 2019. The overall CVH was evaluated by the LE8 score (range, 0–100), as well as the score for each component of diet, physical activity, tobacco/nicotine exposure, sleep duration, body mass index, non–high-density lipoprotein cholesterol, blood glucose, and blood pressure. Life table method was used to estimate life expectancy by levels of the CVH.

Findings were reported as follows: during a median of 7.8 years of follow-up, 1359 total deaths occurred. The estimated life expectancy at age 50 years was 27.3 years (95% CI, 26.1–28.4), 32.9 years (95% CI, 32.3–33.4), and 36.2 years (95% CI, 34.2–38.2) in participants with low (LE8 score <50), moderate (50≤ LE8 score <80), and high (LE8 score ≥80) CVH, respectively. Equivalently, participants with high CVH had an average 8.9 (95% CI, 6.2–11.5) more years of life expectancy at age 50 years compared with those with low CVH. On average, 42.6% of the gained life expectancy at age 50 years from adhering to high CVH was attributable to reduced cardiovascular disease death.

As reported in an AHA news summary of the published report: The new findings provide evidence "that you can modify your lifestyle to live longer," according to lead study author Dr. Lu Qi, a professor of epidemiology and director of the Tulane University Obesity Research Center in New Orleans. The summary offered additional findings:

Using a 100-point scale, the researchers determined whether participants had low (scoring under 50), moderate (50 to 79) or high (80 or higher) cardiovascular health scores for each of the eight components. They also calculated an overall cardiovascular health score.

Findings also included:

  • People with the highest overall scores had an average 8.9 more years of life expectancy at age 50 than those with the lowest scores.
  • Among the individual components, tobacco use, sleep, physical activity and blood glucose levels had the greatest impact on life expectancy.
  • Compared to people who smoked the most, those who did not smoke lived 7.4 years longer.
  • Those who slept the recommended seven to nine hours per night lived five years longer than those who slept too much or not enough.
  • People who were most physically active lived 4.6 years longer than those who were least active. And those who scored higher for maintaining control of blood glucose lived 4.9 years longer than those with poor blood glucose control.
  • About 42% of the gain in life expectancy was attributable to fewer cardiovascular-related deaths.

Similarly significant associations of CVH with life expectancy were observed in men and women, respectively. Similarly significant associations of CVH with life expectancy were observed in White participants and Black participants but not in Mexican participants. The authors noted that more research needs to be done in other races and ethnicities (eg, Hispanic and Asian).

For more information: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062457

References:

1.Ho JY, Hendi AS. Recent trends in life expectancy across high income countries: retrospective observational study.BMJ. 2018; 362:k2562. doi: 10.1136/bmj.k2562 2.Mehta NK, Abrams LR, Myrskylä M. US life expectancy stalls due to cardiovascular disease, not drug deaths.Proc Natl Acad Sci U S A. 2020; 117:6998–7000. doi: 10.1073/pnas.1920391117

3.Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, et al. Heart disease and stroke statistics-2022 update: a report from the American Heart Association.Circulation. 2022; 145:e153–e639. doi: 10.1161/CIR.0000000000001052

4.Lloyd-Jones DM, Allen NB, Anderson C, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, et al; American Heart Association. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association.Circulation. 2022; 146:e18–e43. doi: 10.1161/CIR.0000000000001078

5.Stamler J, Stamler R, Neaton JD, Wentworth D, Daviglus ML, Garside D, Dyer AR, Liu K, Greenland P. Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women.JAMA. 1999; 282:2012–2018. doi: 10.1001/jama.282.21.2012

6.Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, Kaptoge S, Di Angelantonio E, Stampfer M, Willett WC, et al. Impact of healthy lifestyle factors on life expectancies in the US population.Circulation. 2018; 138:345–355. doi: 10.1161/CIRCULATIONAHA.117.032047

7.Clarke R, Emberson J, Fletcher A, Breeze E, Marmot M, Shipley MJ. Life expectancy in relation to cardiovascular risk factors: 38 year follow-up of 19,000 men in the Whitehall study.BMJ. 2009; 339:b3513. doi: 10.1136/bmj.b3513

8.Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L; NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group. Obesity in adulthood and its consequences for life expectancy: a life-table analysis.Ann Intern Med. 2003; 138:24–32. doi: 10.7326/0003-4819-138-1-200301070-00008

9.Bjørnelv G, Halsteinli V, Kulseng BE, Sonntag D, Ødegaard RA. Modeling Obesity in Norway (The MOON Study): a decision-analytic approach-prevalence, costs, and years of life lost.Med Decis Making. 2021; 41:21–36. doi: 10.1177/0272989X20971589

10.Li K, Hüsing A, Kaaks R. Lifestyle risk factors and residual life expectancy at age 40: a German cohort study.BMC Med. 2014; 12:59. doi: 10.1186/1741-7015-12-59

11.Chudasama YV, Khunti KK, Zaccardi F, Rowlands AV, Yates T, Gillies CL, Davies MJ, Dhalwani NN. Physical activity, multimorbidity, and life expectancy: a UK Biobank longitudinal study.BMC Med. 2019; 17:108. doi: 10.1186/s12916-019-1339-0

12.Di Angelantonio E, Kaptoge S, Wormser D, Willeit P, Butterworth AS, Bansal N, O’Keeffe LM, Gao P, Wood AM, Burgess S, et al. Association of cardiometabolic multimorbidity with mortality.JAMA. 2015; 314:52–60. doi: 10.1001/jama.2015.7008

13.Hasbani NR, Ligthart S, Brown MR, Heath AS, Bebo A, Ashley KE, Boerwinkle E, Morrison AC, Folsom AR, Aguilar D, et al. American Heart Association’s Life’s Simple 7: lifestyle recommendations, polygenic risk, and lifetime risk of coronary heart disease.Circulation. 2022; 145:808–818. doi: 10.1161/CIRCULATIONAHA.121.053730

14.Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, Palaniappan L, Piña IL, Ramirez SM, Rodriguez B, et al; American Heart Association Council on Epidemiology and Prevention. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association.Circulation. 2014; 130:593–625. doi: 10.1161/CIR.0000000000000071

15.Lloyd-Jones DM, Ning H, Labarthe D, Brewer L, Sharma G, Rosamond W, Foraker RE, Black T, Grandner MA, Allen NB, et al. Status of cardiovascular health in US adults and children using the American Heart Association’s new “Life’s Essential 8” metrics: prevalence estimates from the National Health and Nutrition Examination Survey (NHANES), 2013 through 2018.Circulation. 2022; 146:822–835. doi: 10.1161/CIRCULATIONAHA.122.060911

16.Zipf G, Chiappa M, Porter KS, Ostchega Y, Lewis BG, Dostal J. National Health and Nutrition Examination Survey: plan and operations, 1999-2010.Vital Health Stat 1. 2013;1–37.

17.Johnson CL, Paulose-Ram R, Ogden CL, Carroll MD, Kruszon-Moran D, Dohrmann SM, Curtin LR. National Health and Nutrition Examination Survey: analytic guidelines, 1999-2010.Vital Health Stat 2. 2013;1–24.

18.Arias E, Xu J. United States life tables, 2019.Natl Vital Stat Rep. 2022; 70:1–59.

19.Arriaga EE. Measuring and explaining the change in life expectancies.Demography. 1984; 21:83–96.

20.Auger N, Feuillet P, Martel S, Lo E, Barry AD, Harper S. Mortality inequality in populations with equal life expectancy: Arriaga’s decomposition method in SAS, Stata, and Excel.Ann Epidemiol. 2014; 24:575–580, 580.e1. doi: 10.1016/j.annepidem.2014.05.006

21.Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, Greenlund K, Daniels S, Nichol G, Tomaselli GF, et al; American Heart Association Strategic Planning Task Force and Statistics Committee. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond.Circulation. 2010; 121:586–613. doi: 10.1161/CIRCULATIONAHA.109.192703

22.Rasmussen-Torvik LJ, Shay CM, Abramson JG, Friedrich CA, Nettleton JA, Prizment AE, Folsom AR. Ideal cardiovascular health is inversely associated with incident cancer: the Atherosclerosis Risk in Communities study.Circulation. 2013; 127:1270–1275. doi: 10.1161/CIRCULATIONAHA.112.001183

23.Sabia S, Fayosse A, Dumurgier J, Schnitzler A, Empana JP, Ebmeier KP, Dugravot A, Kivimäki M, Singh-Manoux A. Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study.BMJ. 2019; 366:l4414. doi: 10.1136/bmj.l4414

24.Fretts AM, Howard BV, McKnight B, Duncan GE, Beresford SA, Mete M, Zhang Y, Siscovick DS. Life’s Simple 7 and incidence of diabetes among American Indians: the Strong Heart Family Study.Diabetes Care. 2014; 37:2240–2245. doi: 10.2337/dc13-2267

25.Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy.Circulation. 1999; 99:2192–2217. doi: 10.1161/01.cir.99.16.2192

26.Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases.Annu Rev Public Health. 2005; 26:469–500. doi: 10.1146/annurev.publhealth.26.021304.144542

27.Dong C, Rundek T, Wright CB, Anwar Z, Elkind MS, Sacco RL. Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across Whites, Blacks, and Hispanics: the Northern Manhattan Study.Circulation. 2012; 125:2975–2984. 10.1161/CIRCULATIONAHA.111.081083

28.Woloshin S, Schwartz LM, Welch HG. The risk of death by age, sex, and smoking status in the United States: putting health risks in context.J Natl Cancer Inst. 2008; 100:845–853. doi: 10.1093/jnci/djn124

29.Chiang CL; World Health Organization. Life table and mortality analysis. 1979. Publisher: Geneva: World Health Organization.


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