Abstract Body (Do not enter title and authors here): Background:
Higher arterial stiffness contributes to atherogenesis and arterial calcification, resulting in cardiovascular morbidity and mortality.
Research Question:
The relations of lifestyle, measured by the AHA Life’s Essential 8 (LE8), with arterial health (AH) and CVD outcomes are incompletely understood.
Aims:
To examine the association of LE8 with AH and extent to which carotid-femoral pulse wave velocity (PWV) mediates the association of LE8 with outcomes in a sample free of CVD.
Methods:
In 3 Framingham Heart Study cohorts, we studied the relations of LE8 (total score and components) with AH, assessed by arterial stiffness (PWV, by tonometry) and coronary calcification score (CAC, by computed tomography) using multivariable-adjusted linear regression (p<0.01 considered significant after Bonferroni correction). We evaluated the extent to which PWV mediates the association of LE8 with outcomes using Cox proportional hazards regression models (p<0.05 considered significant).
Results:
We studied 5222 participants, aged 50±15 years, 56% women. Characteristics of the sample are presented in Table. Higher LE8 score (better cardiovascular health) was associated with more favorable AH measures (PWV inverse transformed, standardized; CAC log(CAC+1); all β±SE, x10^-3): β_PWV=-14.4±0.7, β_CAC=-51.9±7.8, both p<0.01). Of the LE8 components, BMI (β_PWV=-1.53±0.31), BP (β_PWV=-9.74±0.36), fasting glucose (β_PWV=2.03±0.45), lipids (β_PWV=-1.54±0.31, β_CAC=-16.14±3.30) and smoking (β_CAC=-17.9±2.8) were the greater contributors to AH (all p<0.01). PWV mediated modest degrees of the associations between LE8 and CHD, HF, CVD, and CVD mortality [Figure].
Conclusions:
In people without prevalent CVD, healthier lifestyle was associated with better AH. Arterial stiffness mediates the association between lifestyle measures and CHD, HF, CVD, and CVD-mortality. Our results support studying lifestyle interventions to improve arterial health and their benefits for CVD outcomes.