Abstract
BACKGROUND: Chronic respiratory diseases (CRDs) pose a global health challenge. While individual lifestyle factors are known to influence CRDs risk, the collective role of comprehensive cardiovascular health (CVH) metrics remains less clear. Life's Essential 8 (LE8) provides a holistic measure of CVH, but its association with CRDs and related mortality is not well-established at the population level. METHODS: The observational study was based on the US National Health and Nutrition Examination Survey (NHANES 2007-2018). We adjusted for confounding factors and used survey-weighted logistic regression analysis to assess the association between LE8 and the risk of CRDs and the subtypes. Restricted cubic splines (RCS) evaluated non-linear relationships. Subgroup and sensitivity analyses were also conducted. Cox models investigated LE8's impact on all-cause and chronic lower respiratory diseases (CLRDs) mortality. RESULTS: The observational study included 30,863 participants. After adjusting for confounders, survey-weighted logistic regression demonstrates a negative association between LE8 and the risk of CRDs and the four subtypes, with emphysema showing the most significant association (OR = 0.96, 95 % CI: 0.95, 0.97, P < 0.001). RCS suggests a non-linear relationship between LE8 and CRDs. Subgroup and sensitivity analyses confirm the robustness of the results. Compared to individuals with low CVH, those with high CVH have lower risks of all-cause mortality and CLRDs mortality (HR = 0.82, 95 % CI: 0.71, 0.93, P = 0.003; HR = 0.27, 95 % CI: 0.08, 0.88, P = 0.030). CONCLUSION: LE8 inversely correlates with CRDs, and high CVH protects against all-cause and CLRDs mortality.