Life’s Essential 8 cardiovascular health, cardiovascular-kidney-metabolic syndrome stages, and incident cardiovascular events: a nationwide 10-year prospective cohort study in China
Authors' conclusion
The study indicated that cardiovascular-kidney-metabolic stage was associated with cardiovascular events, and optimal cardiovascular health could attenuate this risk. Health factor contributed predominantly at the early-stage, whereas health behavior exhibited consistent and slightly increased contribution along the spectrum. These findings support the utility of cardiovascular-kidney-metabolic construct and highlight the importance of target health improvement based on LE 8 framework.
Study context
- Population
- Individuals in the China Cardiovascular Disease and Cancer Cohort with complete data on CKM factors and LE 8 metrics
- Participants
- 100,727 individuals
- Exposure
- CKM stages 1–4 vs stage 0; optimal vs suboptimal cardiovascular health (CVH)
- Outcome
- Incident CVD events:
- Cardiovascular death
- MI
- Stroke
- Follow-up
- Median 10.1 years
Methodological detailsnationwide, Fine-Gray competing-risk model
- Nationwide
- Fine-Gray competing-risk model
Main finding
As reported in the abstract
CVD events by CKM stage
Each group vs stage 0Adjusted competing HR (95% CI)
Stage 1
1.20(0.95–1.51)
Stage 2
2.45(1.97–3.04)
Stage 3
4.43(3.53–5.58)
Stage 4
5.95(4.75–7.45)
Observational data: associations, not effects.
Further findings
CVH status and CVD events
- Optimal CVH status and each optimal CVH metric presented a significantly decreased risk of CVD events
- Participants in stage 1 or 2 with optimal CVH no longer had elevated risks for incident CVD events vs stage 0
Population attributable fractions to CVD events
- Suboptimal health factor, CKM stage 0-2
- 51.2%
- Suboptimal health factor, CKM stage 3-4
- 25.2%
- Suboptimal health behavior, CKM stage 0-2
- 13.1%
- Suboptimal health behavior, CKM stage 3-4
- 18.2%
Original publication
Life’s Essential 8 cardiovascular health, cardiovascular-kidney-metabolic syndrome stages, and incident cardiovascular events: a nationwide 10-year prospective cohort study in China. Cardiovasc Diabetol. Published 9 May 2025. doi:10.
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