ArticleCardiovascular diabetology2025
Life's Essential 8 cardiovascular health, cardiovascular-kidney-metabolic syndrome stages, and incident cardiovascular events: a nationwide 10-year prospective cohort study in China.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Intensive Blood Pressure Control and Cardiovascular Outcomes Across Cardiovascular-Kidney-Metabolic Syndrome Stages: A Post Hoc Analysis of the China Rural Hypertension Control Project.JAMA network open · 2026Trial
- Cardiovascular-Kidney-Metabolic Syndrome, Healthy Lifestyles, and Risk of Cancer Incidence and Mortality: A Prospective Cohort Study.International journal of cancer · 2026Article
- Association of residential greenness and Life's Essential 8 with cardiovascular disease in China.Cell reports. Medicine · 2026Article
- Associations of Physical Activity With Mortality Across Cardiovascular-Kidney-Metabolic Syndrome Stages: Evidence From NHANES 1999 to 2018.Journal of the American Heart Association · 2026Article
- Cardiovascular-Kidney-Metabolic (CKM) Syndrome Staging and Relevance to Precision Nutrition.Nutrients · 2026Review
- Cardiovascular-kidney-metabolic syndrome: a comprehensive review of pathophysiology, epidemiology, diagnosis, and management.Cardiovascular diabetology · 2026Review
- Emerging multidimensional biomarker system for cardiovascular-kidney-metabolic syndrome: from multi-omics integration to clinical artificial intelligence.Cardiovascular diabetology · 2026Review
- Bridging the Gut Microbiota and the Brain, Kidney, and Cardiovascular Health: The Role of Probiotics.Probiotics and antimicrobial proteins · 2026Review
- Associations between cardiovascular-kidney-metabolic syndrome staging and risks of all-cause and cardiovascular mortality: a systematic review and meta-analysis.American journal of preventive cardiology · 2026Article
- Development of an Explainable Machine Learning Model for Cardiovascular-Kidney-Metabolic Syndrome Prediction Based on Dietary Antioxidants in a National Population.Journal of vascular research · 2026Article
- Behavioral and health-factor domains of Life's Essential 8 in advanced cardiovascular-kidney-metabolic syndrome among Korean adults: a nationally representative cross-sectional analysis.Frontiers in endocrinology · 2026Article
- Diabetes heterogeneity beyond 3.8 years: missed risks of silent hypoglycaemia and long-term complications in the 4C study. Reply to Liu W, Deng B [letter].Diabetologia · 2026Article
- Association between dietary B vitamin intakes and advanced cardiovascular-kidney-metabolic syndrome: insights from the National Health and Nutrition Examination Survey and an external hospital-based dataset.Frontiers in nutrition · 2026Article
- Association of hemoglobin glycation index with the severity and mortality of cardiovascular-kidney-metabolic syndrome: a population-based cohort study.Cardiovascular diabetology. Endocrinology reports · 2025Article
- Urinary Albumin-to-Creatinine Ratio, Cardiovascular Health, and All-Cause Mortality in Hypertension: A Nationwide Cohort Analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
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45 authors.
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Abstract
backgroundDefinition and staging rationale of cardiovascular-kidney-metabolic syndrome were developed. The utility of cardiovascular-kidney-metabolic construct in risk stratification and target strategies of health and behavior modifications needs to be addressed. The study aims to investigate the individual and combined associations of cardiovascular-kidney-metabolic stage and cardiovascular health (CVH) by Life's Essential 8 (LE 8) with incident cardiovascular events (CVD), and determine the distribution and contribution of domain-specific CVH across cardiovascular-kidney-metabolic stages.
methodsThe study included 100,727 individuals in the China Cardiovascular Disease and Cancer Cohort with complete data on cardiovascular-kidney-metabolic factors and LE 8 metrics, with a median follow-up of 10.1 years. Cardiovascular-kidney-metabolic stages and CVH metrics (nicotine exposure, diet, physical activity, sleep, body mass index, blood lipids, blood pressure, blood glucose) were defined according to Presidential Advisory from the American Heart Association. Incident CVD events including cardiovascular death, myocardial infarction, and stroke were validated. The Fine-Gray hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of CKM stages or CVH status associated with CVD.
resultsCompared with cardiovascular-kidney-metabolic stage 0, the adjusted competing HRs and 95% CIs of CVD events were 1.20 (0.95-1.51), 2.45 (1.97-3.04), 4.43 (3.53-5.58), and 5.95 (4.75-7.45) from stage 1 to stage 4, respectively. Optimal CVH status and each optimal CVH metric presented a significantly decreased risk of CVD events. Variation was observed in the association between cardiovascular-kidney-metabolic stage and CVD events with different CVH status or numbers of optimal CVH metrics. Compared with those in stage 0, Participants in stage 1 or 2 with optimal CVH no longer had elevated risks for incident CVD events. Suboptimal health factor contributed larger population attributable fractions to CVD events in cardiovascular-kidney-metabolic stage 0-2 (51.2%) than in stage 3-4 (25.2%), whereas suboptimal health behavior exhibited larger contribution in advanced stages (13.1% in stage 0-2 and 18.2% in stage 3-4).
conclusionsThe study indicated that cardiovascular-kidney-metabolic stage was associated with cardiovascular events, and optimal cardiovascular health could attenuate this risk. Health factor contributed predominantly at the early-stage, whereas health behavior exhibited consistent and slightly increased contribution along the spectrum. These findings support the utility of cardiovascular-kidney-metabolic construct and highlight the importance of target health improvement based on LE 8 framework.
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