The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study

Abstract Background Hypertension can lead to an increased risk of heart failure and death. The life’s essential 8 (LE8) is an eight-factor measure of cardiovascular health recently released by the American Heart Association for use in measuring cardiovascular health. However, evidence on the benefic...

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Main Authors: Jing Wang, Shuilin Wu, Liuxin Li, Jing Wu, Shiqiu Meng, Xueying Qin, Xin Chen, Shoulin Wu, Jie Shi, Yanping Bao, Feng Wang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22422-y
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author Jing Wang
Shuilin Wu
Liuxin Li
Jing Wu
Shiqiu Meng
Xueying Qin
Xin Chen
Shoulin Wu
Jie Shi
Yanping Bao
Feng Wang
author_facet Jing Wang
Shuilin Wu
Liuxin Li
Jing Wu
Shiqiu Meng
Xueying Qin
Xin Chen
Shoulin Wu
Jie Shi
Yanping Bao
Feng Wang
author_sort Jing Wang
collection DOAJ
description Abstract Background Hypertension can lead to an increased risk of heart failure and death. The life’s essential 8 (LE8) is an eight-factor measure of cardiovascular health recently released by the American Heart Association for use in measuring cardiovascular health. However, evidence on the beneficial effects and necessity of LE8 control is still lacking, especially for hypertension. Methods The study population was drawn from the Kailuan cohort, hypertensive population at baseline with the non-hypertensive population matched 1:1 according to age and sex were involved in this analysis. The cut off value for each factor in LE8 was 50 (≥ 50 as controlled, < 50 as uncontrolled). The primary outcomes involved heart failure and all-cause mortality. Cox proportional risk regression models were used to analyze the relationship between the degree of LE8 control and the risk of heart failure and all-cause mortality among hypertensive participants. Hazard ratio (HR) and 95% confidence interval (95% CI) were calculated. Results A baseline population of 69,032 Kailuan cohort with a mean age of 53.08 years (SD 10.59) was included in the study. During a mean follow-up period of 13.17 years (SD 2.57), 1308 (3.8%) heart failures and 5391 (15.6%) deaths occurred among hypertensive patients. In the hypertensive population, there was a negative dose response between the degree of LE8 control and the risk of heart failure or death (P for trend < 0.001). Compared with the group with the control less than or equal to 2 risk factors of LE8, the group with 6 or more risk factors of control had a 55% lower risk of heart failure (HR 0.45, 95% CI 0.26–0.77; P < 0.05) and a 31% lower risk of death (HR 0.69, 95% CI 0.50–0.93; P < 0.05). Compared with the non-hypertensive population, the risk of heart failure and death decreased with increasing of the number of risk factor controlled in LE8, down to a minimum of 1.27-fold (HR 1.27, 95%CI 1.13–1.42; P < 0.05) and 1.25-fold (HR 1.25, 95%CI 1.19–1.32; P < 0.05), respectively. In addition, the association between hypertension and heart failure or mortality was higher in participants aged < 60 years compared with older individuals (P for interaction < 0.05). Conclusions Enhanced control of LE8 is significantly associated with a reduced risk of heart failure and mortality in hypertensive patients, as well as a decreased likelihood of hypertension-related heart failure or mortality.
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spelling doaj-art-0bbe50b08b894b9dbede9e66c6a712842025-08-20T03:10:10ZengBMCBMC Public Health1471-24582025-04-0125111110.1186/s12889-025-22422-yThe role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort studyJing Wang0Shuilin Wu1Liuxin Li2Jing Wu3Shiqiu Meng4Xueying Qin5Xin Chen6Shoulin Wu7Jie Shi8Yanping Bao9Feng Wang10Institute of Advanced Clinical Medicine, Peking UniversitySchool of Public Health, Peking UniversityHealth Care Center, Kailuan Medical GroupChinese Center for Health EducationSchool of Public Health, Peking UniversityNational Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking UniversitySchool of Public Health, Peking UniversityHealth Care Center, Kailuan Medical GroupNational Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking UniversityNational Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking UniversityChinese Center for Health EducationAbstract Background Hypertension can lead to an increased risk of heart failure and death. The life’s essential 8 (LE8) is an eight-factor measure of cardiovascular health recently released by the American Heart Association for use in measuring cardiovascular health. However, evidence on the beneficial effects and necessity of LE8 control is still lacking, especially for hypertension. Methods The study population was drawn from the Kailuan cohort, hypertensive population at baseline with the non-hypertensive population matched 1:1 according to age and sex were involved in this analysis. The cut off value for each factor in LE8 was 50 (≥ 50 as controlled, < 50 as uncontrolled). The primary outcomes involved heart failure and all-cause mortality. Cox proportional risk regression models were used to analyze the relationship between the degree of LE8 control and the risk of heart failure and all-cause mortality among hypertensive participants. Hazard ratio (HR) and 95% confidence interval (95% CI) were calculated. Results A baseline population of 69,032 Kailuan cohort with a mean age of 53.08 years (SD 10.59) was included in the study. During a mean follow-up period of 13.17 years (SD 2.57), 1308 (3.8%) heart failures and 5391 (15.6%) deaths occurred among hypertensive patients. In the hypertensive population, there was a negative dose response between the degree of LE8 control and the risk of heart failure or death (P for trend < 0.001). Compared with the group with the control less than or equal to 2 risk factors of LE8, the group with 6 or more risk factors of control had a 55% lower risk of heart failure (HR 0.45, 95% CI 0.26–0.77; P < 0.05) and a 31% lower risk of death (HR 0.69, 95% CI 0.50–0.93; P < 0.05). Compared with the non-hypertensive population, the risk of heart failure and death decreased with increasing of the number of risk factor controlled in LE8, down to a minimum of 1.27-fold (HR 1.27, 95%CI 1.13–1.42; P < 0.05) and 1.25-fold (HR 1.25, 95%CI 1.19–1.32; P < 0.05), respectively. In addition, the association between hypertension and heart failure or mortality was higher in participants aged < 60 years compared with older individuals (P for interaction < 0.05). Conclusions Enhanced control of LE8 is significantly associated with a reduced risk of heart failure and mortality in hypertensive patients, as well as a decreased likelihood of hypertension-related heart failure or mortality.https://doi.org/10.1186/s12889-025-22422-yLife’s essential 8Heart failureAll-cause mortalityHypertensionKailuan study
spellingShingle Jing Wang
Shuilin Wu
Liuxin Li
Jing Wu
Shiqiu Meng
Xueying Qin
Xin Chen
Shoulin Wu
Jie Shi
Yanping Bao
Feng Wang
The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study
BMC Public Health
Life’s essential 8
Heart failure
All-cause mortality
Hypertension
Kailuan study
title The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study
title_full The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study
title_fullStr The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study
title_full_unstemmed The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study
title_short The role of the control of “life’s essential 8” for prevention on heart failure and all-cause mortality in patients with hypertension: the Kailuan cohort study
title_sort role of the control of life s essential 8 for prevention on heart failure and all cause mortality in patients with hypertension the kailuan cohort study
topic Life’s essential 8
Heart failure
All-cause mortality
Hypertension
Kailuan study
url https://doi.org/10.1186/s12889-025-22422-y
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