A collaborative study by the Institute of Nutrition, Fudan University, Kailuan General Hospital of Hebei Province, and Shanghai Jiao Tong University School of Medicine —— has produced important research findings using data from the Kailuan Study, a large-scale Chinese cohort study. The results were published in Chinese Medical Journal under the title "Association between life's essential 8 and risk of heart failure: A prospective community-based study." Dr. Wu Zhijun, Associate Researcher at Shanghai Jiao Tong University School of Medicine, is the first author of the paper, and Professor Wu Shouling of Kailuan General Hospital of Hebei Province is the corresponding author.
1、Background
Despite continuous advances in diagnostic and therapeutic approaches, heart failure (HF) remains a global public health burden, and its high mortality rate urgently needs to be addressed. Metabolic disorders and lifestyle factors play a critical role in the development and prognosis of HF; however, conventional intervention strategies have mostly focused on the management of single risk factors and lack a systematic assessment of multidimensional health metrics.
The "Life's Essential 8 (LE8)" metrics optimize the cardiovascular health assessment framework on the basis of the original model, advocating for reducing the burden of cardiovascular disease by improving lifestyle and controlling metabolic risk. Yet its predictive efficacy and mechanisms for HF still lack validation in large prospective cohorts. Previous studies have overlooked the dynamic predictive value of LE8 for HF risk and its heterogeneity across different high-risk subgroups (such as patients with chronic kidney disease). In addition, the mechanisms by which behavioral factors (such as physical activity and diet) and metabolic factors (such as blood pressure and blood glucose) act synergistically to influence HF remain unclear.
2、Findings
This study conducted a prospective analysis of 68,885 participants without cardiovascular disease at baseline, revealing a significant negative correlation between cardiovascular health scores and HF risk. The study found that participants with higher cardiovascular health scores (based on LE8, 0–100 points) had a significantly lower incidence of HF. Cox regression analysis showed that, compared with participants with a cardiovascular health score <50 (inadequate), those with a score ≥70 (optimal) had a 54% lower risk of HF (HR=0.46, 95% CI: 0.33–0.64) and a 62% lower risk of all-cause death after HF onset (HR=0.38, 95% CI: 0.18–0.80). In addition, participants with ≥6 ideal LE8 metrics had a 56% lower risk of HF compared with those with ≤1 (HR=0.44, 95% CI: 0.24–0.80). Cluster analysis indicated that participants with both ≥3 ideal behavioral factors (smoking, diet, physical activity, sleep) and ≥3 ideal metabolic factors (body mass index, blood pressure, blood lipids, blood glucose) had the lowest HF risk. Mediation analysis further revealed that LE8 metrics partially mediated the reduction in HF risk through pathways such as improving left ventricular structure and function and reducing inflammation and vascular stiffness.
This study is the first to reveal the core value of LE8 metrics in the primary prevention of HF, providing evidence-based support for community-level cardiovascular health interventions.
Full Article：
https://doi.org/10.1097/CM9.0000000000003598
3、Authors
Dr. Wu, Zhijun
MD, Associate Chief Physician, Associate Researcher; Member of the Cardio-Oncology Committee of the Cardiovascular Disease Branch of the Chinese Medical Doctor Association; Member of the American Society for Nutrition.
Dr. Wu, Shouling
MD, Chief Physician, Professor, Master's Advisor, and an expert entitled to the Special Government Allowance of the State Council. Principal Investigator of the Kailuan Study. He currently serves as an editorial board member of the Chinese Journal of Cardiovascular Medicine, the Chinese Circulation Journal, and the Chinese Journal of Hypertension, a member of the Hypertension Branch of the Chinese Medical Doctor Association, and a council member of the Fifth Council of the Chinese Hypertension League. He has been engaged in basic and clinical research on hypertension and cardiovascular diseases since 1999. In recent years, he has published more than 250 SCI-indexed papers, over 400 papers in national core journals such as the Chinese Journal of Cardiovascular Medicine and the Chinese Journal of Hypertension, and more than 20 monographs.
Dr. Gao, Xiang
Dean of the Institute of Nutrition, Fudan University and Professor at the School of Public Health. He previously served as a tenured Professor in the Department of Nutritional Sciences and Director of the Nutritional Epidemiology Laboratory at Pennsylvania State University, a Schreyer Honors Distinguished Faculty member at Pennsylvania State University, Associate Epidemiologist at Brigham and Women's Hospital, an affiliate of Harvard University, and Assistant Professor at Harvard Medical School. He also serves as a member of the Advisory Committee of the UNESCO Center for Creativity and Sustainable Development, an expert for the Food and Agriculture Organization of the United Nations, a Chief Expert (Nutritional Epidemiology) of the Chinese Nutrition Society, a member of the "Committee on Nutrition, Brain, and Trauma" of the National Academy of Medicine of the United States, and former Chair of the Nutritional Epidemiology Group of the American Society for Nutrition and the Environmental Genetics Group of the American Parkinson's Disease Association. His research interests include nutrition, sleep, and aging-related diseases. He has long been engaged in large-scale cohort studies, such as the Nurses' Health Study in the United States, the Pennsylvania Rural Older Adult Cohort, and the Kailuan Cohort in China. He has published more than 400 SCI-indexed papers, and his research findings have been reported numerous time by mainstream media worldwide.
