Effect of Life’s Essential 8 and Exposure to Solid Fuels for Cooking on Cardiovascular Disease Risk

BACKGROUND: Few studies have examined the association between Life's Essential 8 (LE8) scores and cardiovascular disease (CVD) risk in less-developed countries. In this study we aimed to assess the relationship between LE8 levels and CVD and evaluate whether LE8 modifies the association between exposure to solid cooking fuels and CVD. METHODS: A cross-sectional analysis was conducted using data extracted from the China Multi-Ethnic Cohort. Cardiovascular health was scored using LE8 and categorized as low, moderate, and high. Exposure to solid fuels for cooking was classified as no exposure, intermediate exposure, and heavy exposure. RESULTS: Among 89,772 participants, 4444 (5.0%) had CVD. Higher LE8 scores were associated with lower CVD risk after full covariate adjustment. The adjusted odds ratios (95% confidence intervals [CIs]) for the moderate and high LE8 groups were 0.82 (0.74-0.89) and 0.73 (0.66-0.81), respectively (P for trend < 0.001). Compared with no exposure, heavy exposure to solid fuels was associated with a higher CVD risk (odds ratio, 1.21 [95% CI, 1.06-1.40]; P = 0.004). A significant interaction was observed between the LE8 score and solid fuel exposure (P for interaction = 0.01). The inverse association between LE8 and CVD was the strongest among those with no exposure to solid fuels (odds ratio, 0.80 [95% CI, 0.71-0.91]). CONCLUSIONS: High LE8 scores are associated with reduced CVD risk, particularly among participants with no exposure to solid fuels for cooking.