Abstract
BACKGROUND: The associations between birth weight (BW), cardiovascular health (CVH) as assessed by Life's Essential 8 (LE8) and cardiovascular diseases (CVDs) remain unclear. We aimed to assess the independent and joint associations of BW and CVH with risks of CVDs. METHODS: This study included 143,910 UK Biobank participants without CVD at baseline (2006-2010). BW was self-reported, and CVH was evaluated using the LE8 score. Cox models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident total CVD and nine cardiovascular conditions. RESULTS: During a median 15.1-year follow-up, 24,071 CVD cases occurred. Compared with normal BW (2.5-4.0 kg), low BW was associated with increased risks of total CVD (adjusted HR [aHR]: 1.13, 95% CI [1.08 to 1.17], P < 0.001), CVD death (aHR: 1.25 [1.11 to 1.40]), and six other CVDs (aHR ranging from 1.09 to 1.36). High BW was associated with higher risks of aortic aneurysom (aHR: 1.20 [1.03 to 1.39], P = 0.02) and dysrhythmias (aHR: 1.08 [1.03 to 1.14], P = 0.003), but lower risks of peripheral artery disease (aHR: 0.78 [0.67 to 0.91], P = 0.002) and ischemic heart disease (aHR: 0.94 [0.89 to 1.00, P = 0.05). Compared with low LE8 score, high LE8 score was associated with 55%-60% lower risk of total CVD in participants with various BW, and no interactions were found. CONCLUSIONS: Low BW was associated with an increased risk of CVD, whereas high BW showed a neutral association. High CVH, as evaluated by LE8, was associated with a reduced incidence of CVD irrespective of BW.