Life's essential 8 cardiovascular health and depression: Sex-specific associations in a national population-based study.
Depression represents a significant global health burden. While cardiovascular health and depression share a well-established association, the specific relationship between "Life's Essential 8 (LE8)" and depression remains underexplored.
Utilizing data from the National Health and Nutrition Examination Survey (NHANES, 2007-2018), LE8 scores based on American Heart Association guidelines, categorizing cardiovascular health into low (<50), moderate (50-79), and high (≥80) tiers. Depression was defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥ 10. Survey-weighted logistic regression, restricted cubic splines, and mediation analysis were employed to assess associations.
Among the weighted sample of 213,703,729.8 participants (mean age 45.21 years, 50.6 % male), each 1-standard deviation (SD) increase in the LE8 score, the adjusted odds ratio for depression was 0.64 (95 % CI: 0.56-0.73). Compared to the low LE8 group, high and moderate LE8 tiers exhibited substantially lower depression risks (high: OR = 0.29, 95 % CI: 0.18-0.48; moderate: OR = 0.52, 95 % CI: 0.37-0.74, both P < 0.001). Individuals with ≥5 optimal LE8 components demonstrated a 67 % risk reduction versus those with 0-1 components (OR = 0.33, 95 % CI: 0.19-0.57), with each additional component lowering risk by 23 % (OR = 0.77, 95 % CI: 0.66-0.90). Subgroup analyses revealed sex-specific variations: diet contributed most to risk reduction in males (attributable risk proportion = 0.053), while BMI was predominant in females (0.052). Mediation analyses identified cardiovascular disease (CVD; 29 % mediation) and obstructive sleep apnea (OSA; 12.2 % mediation) as partial mechanistic pathways.
LE8 scores exhibit a robust inverse association with depression risk, modulated by sex-specific component contributions and mediated through CVD and OSA. These findings underscore the value of tailored interventions.
Utilizing data from the National Health and Nutrition Examination Survey (NHANES, 2007-2018), LE8 scores based on American Heart Association guidelines, categorizing cardiovascular health into low (<50), moderate (50-79), and high (≥80) tiers. Depression was defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥ 10. Survey-weighted logistic regression, restricted cubic splines, and mediation analysis were employed to assess associations.
Among the weighted sample of 213,703,729.8 participants (mean age 45.21 years, 50.6 % male), each 1-standard deviation (SD) increase in the LE8 score, the adjusted odds ratio for depression was 0.64 (95 % CI: 0.56-0.73). Compared to the low LE8 group, high and moderate LE8 tiers exhibited substantially lower depression risks (high: OR = 0.29, 95 % CI: 0.18-0.48; moderate: OR = 0.52, 95 % CI: 0.37-0.74, both P < 0.001). Individuals with ≥5 optimal LE8 components demonstrated a 67 % risk reduction versus those with 0-1 components (OR = 0.33, 95 % CI: 0.19-0.57), with each additional component lowering risk by 23 % (OR = 0.77, 95 % CI: 0.66-0.90). Subgroup analyses revealed sex-specific variations: diet contributed most to risk reduction in males (attributable risk proportion = 0.053), while BMI was predominant in females (0.052). Mediation analyses identified cardiovascular disease (CVD; 29 % mediation) and obstructive sleep apnea (OSA; 12.2 % mediation) as partial mechanistic pathways.
LE8 scores exhibit a robust inverse association with depression risk, modulated by sex-specific component contributions and mediated through CVD and OSA. These findings underscore the value of tailored interventions.
Authors
Liu Liu, Jing Jing, Li Li, Bu Bu, Yin Yin, Xu Xu, Wang Wang, Chen Chen, Shi Shi
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