The Association between Life's Essential 8 and the Risk for Atrial Fibrillation in a Dutch Population

Abstract

BACKGROUND: This study examined the association between Life’s Essential 8 (LE8) and the incidence of atrial fibrillation (AF). METHODS: In total, 37,807 participants from the European Prospective Investigation Into Cancer and Nutrition-Netherlands (EPIC-NL) cohort were included (mean age 49.4 ± 11.9 years, 74.7% women). The components diet, physical activity, sleep health, nicotine exposure, body mass index, blood glucose, blood lipids, blood pressure were all given a score between 0 and 100 and an overall LE8 score was created. The overall LE8 score was averaged and categorized into low cardiovascular health (CVH, 0-49), moderate CVH (50-79), and high CVH (80-100). AF cases were obtained through linkage with registries. RESULTS: During a median follow-up of 15.3 years (interquartile range: 14.1 – 26.5 years), 833 AF cases (2.3%) were identified. Compared to the high CVH score (19.5%), participants with a low CVH score (5%) had a 1.99 times higher hazard for incident AF (hazard ratio = 1.99, 95% confidence interval (CI) = 1.49 – 2.65) in a Cox proportional hazards model adjusted for age, sex, education level, heart failure, coronary heart disease, and alcohol consumption. Furthermore, an ideal component decrease was associated with a 1.11 times higher risk for incident AF (95% CI = 1.05 – 1.18). CONCLUSIONS: The results show that a worse CVH, indicated by a lower LE8 score, is associated with an increased risk for incident AF.