LAUSR

AIMS To evaluate the association of cardiovascular health (CVH), measured by the Life's Essential 8 score, with the risk of premature mortality and to determine the patterns of CVH-related differences in life expectancy among people with and without type 2 diabetes (T2D). MATERIALS AND METHODS This prospective study included 309,789 participants (age 56.6±8.1 years; 46% men) enrolled in the UK Biobank. The Life's Essential 8 composite measure consists of four health behaviors (diet, physical activity, nicotine exposure, sleep) and four health factors (BMI, non-HDL cholesterol, blood glucose, blood pressure), and the maximum CVH score was 100 points. CVH was categorized into low, moderate, and high groups. Premature death was defined as death before the age of 75. Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated, and life expectancy was estimated. RESULTS During a median follow-up of 12.7 years, 13,683 cases of premature death were documented. Compared with participants with low CVH, the multivariable HRs (95% CIs) of premature death were 0.59 (0.56-0.62) and 0.42 (0.39-0.45) for the moderate and high CVH groups, respectively. This association was stronger in participants with T2D compared with those without T2D. At the age of 50 years, compared to low CVH groups, high CVH was associated with a gain of 9.79 (9.70-9.87) and 5.58 (5.48-5.67) additional life years for men with and without T2D, respectively. The corresponding life gain for women with and without T2D was 24.21 (24.13-24.27) and 10.18 (10.10-10.27), respectively. CONCLUSIONS Maintaining an ideal Life's Essential 8 score may provide more benefits for people with T2D than for those without T2D, including a lower risk of premature death and an increased lifespan. This article is protected by copyright. All rights reserved.