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Association between cardiometabolic index change patterns and incident cardiovascular disease in middle-aged and

Hongyan Li1, Hongliang Tian2, Haitao Dong1

  • 1Department of Cardiovascular Medicine, Affiliated Hospital of Chifeng University, Chifeng, China.

Frontiers in Cardiovascular Medicine
|August 15, 2026
PubMed

Insights

Persistently high cardiometabolic index (CMI) levels significantly increase cardiovascular disease (CVD) risk in older adults. Long-term CMI monitoring and management are crucial for reducing CVD incidence and improving patient outcomes.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Cardiovascular disease (CVD) remains a leading cause of mortality globally.
  • The long-term impact of cardiometabolic index (CMI) changes on CVD risk is not well-established.
  • Understanding CMI dynamics is essential for effective CVD prevention strategies.

Purpose of the Study:

  • To investigate the association between cumulative and long-term changes in the cardiometabolic index (CMI) and the risk of incident cardiovascular disease (CVD).
  • To explore the dose-response relationship between CMI trajectories and CVD incidence.
  • To analyze CMI change patterns in diverse populations.

Main Methods:

  • Utilized data from the China Health and Retirement Longitudinal Survey (CHARLS), English Longitudinal Study of Ageing (ELSA), and hospital Electronic Medical Records (EMR).
  • Employed K-means clustering to identify distinct CMI change patterns.
  • Applied Cox proportional hazards models and restricted cubic spline analysis to assess associations and dose-response relationships between CMI and CVD risk.

Main Results:

  • Higher CMI trajectory groups demonstrated significantly increased CVD incidence risk across all cohorts, even after adjustments.
  • A nonlinear dose-response relationship was observed between cumulative CMI and CVD risk.
  • Hazard ratios for incident CVD were elevated in the highest CMI groups compared to the lowest, indicating a substantial risk increase.

Conclusions:

  • Persistently elevated cardiometabolic index (CMI) levels are strongly associated with a higher risk of incident cardiovascular disease (CVD) in middle-aged and older adults.
  • Long-term monitoring and management of CMI are vital for reducing CVD incidence.
  • These findings underscore the importance of CMI in cardiovascular health and prognosis.
Abstract

Keywords:
cardiometabolic indexcardiovascular diseasechange patterncumulative effecttrajectory

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