The average life expectancy has substantially increased in the past few decades in the U.S. and in most industrialized countries. However, not all these increases in years of life are benefitting in terms of optimal health.
The following study attempted to quantify the associations between levels of cardiovascular health (CVH), described by the American Heart Association, and their Life’s Essential 8 metrics, with life expectancy free of major chronic disease, including cardiovascular disease (CVD), diabetes, cancer, and dementia in adults in the United Kingdom.
The study cohort included 135,199 adults in the UK Biobank study. They were initially free of major chronic disease and had data on the life’s Essential 8 metrics.
The Life’s Essential 8 (LE8) score consists of eight components:
(1) diet,
(2) physical activity,
(3) tobacco/nicotine exposure,
(4) sleep,
(5) body mass index,
(6) non-high-density lipoprotein cholesterol,
(7) blood glucose, and
(8) blood pressure.
The CVH level was evaluated at baseline and categorized into low (LE8 score <50), moderate (LE8 score ≥50 but <80), and high (LE8 score ≥80) levels. The primary outcome was the life expectancy free of four major chronic diseases (CVD, diabetes, cancer, and dementia).
Of the 135,199 adults, a total of 4,712/48,955/and 6,748 men had low, moderate, and high CVH levels, respectively. The numbers for women were 3,661/ 52,192/ and18,931. At age 50 years, the estimated disease-free years were 21.5, 25.5, and 28.4 for men with low, moderate, and high CVH levels, respectively. For women, the estimated disease-free years at age 50 were 24.2, 30.5, and 33.6. Men with moderate or high cardiovascular health levels lived on average 4.0 or 6.9 years longer free of chronic disease, respectively, at age 50 years, compared with men with low cardiovascular health levels. The corresponding years longer lived free of disease for women were 6.3 or 9.4 years. These benefits were true and similar regardless of socioeconomic level, educational background, income level, and the Townsend depravation score (measure of adversity)
Conclusions and relevance: In this cohort study, a high level of cardiovascular health was evaluated using the LE8 metrics, and was associated with longer life expectancy free of major chronic diseases and may contribute to narrowing socioeconomic health inequalities in both men and women. This is an excellent reminder of the many benefits, even if we do nothing more with our patients than stick to some basics.
Here’s a reminder of Life’s Essential 8 from the American Heart Association:
- Eat better
- More active
- Nicotine free
- Healthy sleep (7-9 hours)
- Manage weight
- Control cholesterol
- Manage BP
- Manage blood sugar
Here is a summary if one scores high on these metrics:
- Longer life expectancy (men = 25 years; women = 30 years
- Longer health span: Longer life free of chronic disease (Cancer, CVD, DM, Dementia)
- Women: high score vs low score: extra 9.5 years free of chronic disease if score high on the metrics
- Men: high score vs low score: extra 7 years free of chronic disease if score high on the metrics
Reference:
Wang X, Ma H, Li X, et al. Association of Cardiovascular Health With Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK Adults. JAMA Intern Med. 2023;183(4):340-349.
