| Title: |
Long-Term Cardiovascular Health Trajectories Associated With Cardiovascular Disease and Mortality in Older Adults |
| Authors: |
Yi Li, MA; Yunqing Han, MS; Yuanming Leng, MS; Madeleine Carbonneau, BS; Yanping Li, PhD; Daniel Levy, MD; Chunyu Liu, PhD; Jiantao Ma, PhD |
| Source: |
JACC: Advances, Vol 5, Iss 2, Pp 102502- (2026) |
| Publisher Information: |
Elsevier, 2026. |
| Publication Year: |
2026 |
| Collection: |
LCC:Diseases of the circulatory (Cardiovascular) system; LCC:Medical emergencies. Critical care. Intensive care. First aid |
| Subject Terms: |
cardiovascular health; Life’s essential 8; cardiovascular disease; mortality; Diseases of the circulatory (Cardiovascular) system; RC666-701; Medical emergencies. Critical care. Intensive care. First aid; RC86-88.9 |
| Description: |
Background: Maintaining cardiovascular health (CVH) is essential for preventing cardiovascular disease (CVD). Objectives: We aimed to evaluate associations of changes in CVH with CVD and mortality. Methods: We assessed CVH using Life’s Essential 8 (LE8) in 3,364 participants from Framingham Heart Study Offspring cohort. Trajectory analysis was performed to identify LE8 changing patterns from young adulthood to middle age. We also quantified LE8 changes during the late middle and early older adulthood. Cox models were used to evaluate associations with incident CVD and all-cause mortality. Results: Four CVH trajectory groups were identified during a follow-up of 20 years, extending to age 60 years: stable low (11%), improved (17%), rapid decline (9%), and stable high (63%). Compared to stable low group, improved and stable high groups had lower CVD (HR: 0.52; P = 2.55e-7; HR: 0.69; P = 0.002, respectively) and mortality risk (HR: 0.67; P = 7.05e-5; HR: 0.81; P = 0.03, respectively) after age 60 years. Although CVD risk was similar between rapid-decline and stable-low groups (HR: 1.13; P = 0.5), rapid-decline group had higher mortality (HR: 1.51; P = 0.007). In the joint analysis with CVD polygenic risk scores, individuals with low or high polygenic risk score had similar CVD risk in each LE8 trajectory groups. Furthermore, LE8 improvement over 12-year follow-up (starting at ages 60-65 years) was associated with a lower incident CVD risk and all-cause mortality. Conclusions: Maintaining a high CVH or improving CVH over time was associated with lower CVD risk and longer lifespan. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2772-963X |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2772963X25009317; https://doaj.org/toc/2772-963X |
| DOI: |
10.1016/j.jacadv.2025.102502 |
| Access URL: |
https://doaj.org/article/bc0fd1cd6f2c4f539ebe01ffcd8a3f34 |
| Accession Number: |
edsdoj.bc0fd1cd6f2c4f539ebe01ffcd8a3f34 |
| Database: |
Directory of Open Access Journals |