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Association between life's crucial 9 and stroke: results from the NHANES 2005-2018
Xiaodong Chen1, Yifan Xu1, Chao Wang1
1Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao, Shangdong, 266000, China.
Insights
Higher Life's Crucial 9 (LC9) scores, reflecting better cardiovascular health, are linked to significantly lower stroke prevalence in US adults. Maintaining a good LC9 score may be a key strategy for stroke prevention.
Area of Science:
- Cardiovascular Health
- Epidemiology
- Public Health
Background:
- Life's Crucial 9 (LC9) is a composite score of nine modifiable cardiovascular health factors.
- Understanding the association between LC9 scores and stroke prevalence is crucial for public health strategies.
Purpose of the Study:
- To examine the relationship between Life's Crucial 9 (LC9) scores and the prevalence of stroke in a representative sample of US adults.
Main Methods:
- Cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data (2005-2018).
- LC9 scores were categorized into quartiles.
- Weighted multivariable logistic regression, subgroup analyses, and restricted cubic spline (RCS) modeling were employed to assess the association between LC9 scores and stroke prevalence.
Main Results:
- A total of 19,207 participants were analyzed, with an overall stroke prevalence of 2.87%.
- Each one-point increase in LC9 score was associated with a 4.7% decrease in stroke odds (p < 0.001).
- Individuals in the highest LC9 quartile exhibited a 72.6% lower prevalence of stroke compared to the lowest quartile (p < 0.001). The association was linear and consistent across demographic subgroups.
Conclusions:
- Higher Life's Crucial 9 (LC9) scores are significantly associated with a reduced likelihood of stroke.
- Optimizing LC9 scores presents a potential avenue for effective stroke prevention strategies.
- Further large-scale prospective studies are warranted to confirm these findings and establish clinical LC9 thresholds.
Background:
Life's Crucial 9 (LC9) is a composite cardiovascular health score comprising nine modifiable factors. This study examines the relationship between LC9 scores and stroke prevalence in US adults.
Methods:
This study conducted a cross-sectional analysis of National Health and Nutrition Examination Survey data from 2005 to 2018. To facilitate analysis, LC9 values were separated into four quartiles. The relationship between LC9 scores and the prevalence of stroke was evaluated using subgroup analysis, restricted cubic spline (RCS) modeling, and weighted multivariable logistic regression.
Results:
Among 19 207 participants with an average LC9 score of 70.70 ± 0.22, the overall stroke prevalence was 2.87 %. Each one-point increase in LC9 score was associated with a 4.7 % reduction in stroke odds (95 % CI 0.943-0.963; p < 0.001). Compared with the lowest LC9 quartile (Q1), individuals in the highest quartile (Q4) had a 72.6 % lower stroke prevalence (95 % CI 0.169-0.446; p < 0.001). Stratified analyses and interaction assessments indicated that the inverse association remained consistent across age, sex, BMI, diabetes, and hypertension categories, with no significant interactions observed. Furthermore, curve fitting analysis identified a linear correlation between LC9 scores and the risk of stroke.
Conclusions:
Our findings indicated that higher LC9 scores were associated with a reduced likelihood of stroke. Preserving a favorable LC9 score may serve as a potential strategy for stroke prevention. To substantiate these observations and establish clinically applicable LC9 thresholds, additional large-scale prospective studies with prolonged follow-up are needed.
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