Life's Essential 8 and heart failure among patients with chronic kidney disease: the Kailuan Cohort Study

Zhenyu Huo; Zhe Huang; Jun Feng; Junjuan Li; Shuohua Chen; Guodong Wang; Yinshun Peng; Lili Huang; Shouling Wu; Xiang Gao; Yaqi Li; Tingting Geng

doi:10.1093/eurjpc/zwad398

Life's Essential 8 and heart failure among patients with chronic kidney disease: the Kailuan Cohort Study

Eur J Prev Cardiol. 2023 Dec 19:zwad398. doi: 10.1093/eurjpc/zwad398. Online ahead of print.

Authors

Zhenyu Huo^{1

2}, Zhe Huang², Jun Feng³, Junjuan Li², Shuohua Chen², Guodong Wang², Yinshun Peng⁴, Lili Huang⁴, Shouling Wu², Xiang Gao⁴, Yaqi Li⁴, Tingting Geng⁴

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, North China University of Science and Technology, Tangshan, China.
² Department of Cardiology, Kailuan General Hospital, Tangshan, China.
³ Zunhua Minzu Hospital, Tangshan, China.
⁴ Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.

PMID: 38113400
DOI: 10.1093/eurjpc/zwad398

Abstract

Aims: Patients with chronic kidney disease (CKD) are at an increased risk of developing heart failure. The American Heart Association recently released a new metric, Life's Essential 8 (LE8), for health promotion. However, evidence regarding associations between LE8 and heart failure risk among patients with CKD is scarce.

Methods: A total of 16,190 patients with CKD (mean age 55.9 years), free of cardiovascular disease at recruitment from the Kailuan study, were included. Cardiovascular health was assessed using the LE8 score. Incident heart failure events were ascertained via linkage of electronic health record data. Cox proportional hazards regression models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: There were 814 (5.0%) patients in the high LE8 criteria, with 13,180 (81.4%) in the moderate, and 2,196 (13.6%) in the low LE8 category, respectively. During a median follow-up of 13.7 years, 724 incident heart failure cases were documented. Compared with the low LE8 category, the HRs (95% CIs) for heart failure were 0.58 (0.48, 0.71) for the moderate LE8 category, and 0.32 (0.19, 0.54) for the high LE8 category (P for trend <0.001). In addition, the association was stronger in patients aged ≤65 years compared with their older counterparts (P for interaction = 0.01).

Conclusion: Our data showed a strong graded inverse association between the LE8-defined cardiovascular health and the risk of heart failure among patients with CKD. Our findings support the importance of adopting the LE8 among patients with CKD to prevent heart failure.

Keywords: Kailuan study; Life’s Essential 8; cardiovascular health; chronic kidney disease; heart failure.

Plain language summary

Using the Life’s Essential 8 (LE8) score, released by the American Heart Association for cardiovascular health promotion, this study investigated the relationship between cardiovascular health and the risk of heart failure in patients with chronic kidney disease (CKD) in China. Patients with CKD who had better cardiovascular health, as indicated by higher LE8 scores, had a significantly lower risk of heart failure.A stronger association between better LE8 score and lower risk of heart failure among CKD patients aged ≤65 years was observed, compared with their older counterparts.