Ten-year trajectory of Life's Essential 8 and aortic valve calcification

The American Heart Association developed Life's Essential 8 (LE8) to improve the predictive ability of cardiovascular health (CVH).

We sought to investigate whether a 10-year CVH trajectory is associated with the prevalence of aortic valve calcification (AVC), an early manifestation of calcific aortic valve disease (CAVD).

The current study included 8047 participants who participated in the surveys at baseline (2006) and during follow-up periods (2008, 2010, 2012, 2014 and 2016). Repeated measurements of LE8 components including body mass index, cigarette smoking, diet quality, physical activity, sleep health, lipids, blood glucose and blood pressure, were used to construct the CVH trajectories. Ten-year CVH trajectory patterns from 2006 to 2016 were constructed using latent mixture models. AVC was diagnosed by echocardiography from 2016 to 2023.

During an eight-year follow-up period, 1005 AVC cases were identified. Compared to the moderate-decrease trajectory, the low-stable trajectory was associated with higher odds of AVC (odd ratio (OR): 1.46; 95% confidence interval (CI): 1.17, 1.83). Participants in the groups of moderate-increasing trajectory (OR: 0.78; 95%CI: 0.62, 0.98), moderate-stable trajectory (OR: 0.62; 95%CI: 0.52, 0.74), and high-stable trajectory (OR: 0.30; 95%CI: 0.20, 0.43) had lower odds of AVC compared with those in the moderate-decreasing trajectory group. The association between the CVH trajectory and AVC prevalence was more pronounced in men, younger individuals and those without chronic kidney disease.

Maintaining or improving CVH was associated with lower odds of AVC. Our findings suggest optimizing CVH may provide a primordial preventive benefit against subclinical CAVD.