{
  "abstract": "Background: The American Heart Association's Life's Essential 8 is a metric used to assess cardiovascular health (CVH) that includes 4 health behaviors and 4 health factors. We examined the association of achievement of Life's Essential 8 with death among American Indian people who participated in the SHFS (Strong Heart Family Study), a study of cardiovascular disease risk factors in 12 rural American Indian communities in the United States.\n\nMethods: A total of 2230 SHFS participants were included. A composite CVH score (0–100) was created on the basis of the achievement of Life's Essential 8 goals except sleep and categorized into low (0–49), moderate (50–69), and high (70–100) CVH. Cox proportional hazards models were used to examine the association of CVH with mortality risk (all‐cause and cardiovascular disease death).\n\nResults: There were 555 deaths over a median 19.3‐year follow‐up. The risk of death from any cause was lower among participants who achieved high CVH (hazard ratio [HR], 0.52 [95% CI, 0.38–0.70]) or moderate CVH (HR, 0.67 [95% CI, 0.56–0.78]) compared with those with low CVH. Similarly, the risk of death from cardiovascular disease was lower among participants with high CVH (HR, 0.30 [95% CI, 0.14–0.67]) or moderate CVH (HR, 0.56 [95% CI, 0.39–0.79]) compared with participants with low CVH.\n\nConclusions: Higher achievement of Life's Essential 8 was associated with lower risk of all‐cause and cardiovascular disease death. This work highlights the importance of promoting optimal CVH to minimize risk of death in American Indian communities.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Epidemiology University of Washington Seattle WA USA",
    "University of Oklahoma Health Sciences Center Oklahoma City OK USA",
    "Department of Medicine University of Washington Seattle WA USA",
    "MedStar Health Research Institute Washington DC USA",
    "Department of Pediatrics University of Washington Seattle WA USA",
    "Department of Family Medicine University of California San Diego San Diego CA USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Pyone Yadanar Paing",
      "orcid": "0000-0002-9136-2538"
    },
    {
      "affs": [
        1
      ],
      "name": "Jessica A. Reese",
      "orcid": "0000-0002-6640-6543"
    },
    {
      "affs": [
        2
      ],
      "name": "Colleen M. Sitlani",
      "orcid": "0000-0001-7656-7482"
    },
    {
      "affs": [
        1
      ],
      "name": "Ying Zhang",
      "orcid": "0000-0001-6945-3743"
    },
    {
      "affs": [
        3
      ],
      "name": "Jason G. Umans",
      "orcid": "0000-0002-2746-3350"
    },
    {
      "affs": [
        4
      ],
      "name": "Reya Mokiao",
      "orcid": "0000-0003-2960-4433"
    },
    {
      "affs": [
        5
      ],
      "name": "Matthew Allison",
      "orcid": "0000-0003-0777-8272"
    },
    {
      "affs": [
        0
      ],
      "name": "Amanda M. Fretts",
      "orcid": "0000-0002-5358-2345"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cy2xx4vd39ds0.bib",
  "cited_by": 0,
  "doi": "10.1161/jaha.125.048758",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13745026/",
  "id": "cy2xx4vd39ds0",
  "issns": [
    "2047-9980"
  ],
  "landing_url": "https://doi.org/10.1161/jaha.125.048758",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Epidemiology"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2705|Cardiovascular Health and Risk Factors"
    ]
  ],
  "openalex": "W7214294697",
  "pdf_url": null,
  "pmcid": "PMC13745026",
  "pmid": "42786619",
  "published": "2026-09-24",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/cy2xx4vd39ds0.ris",
  "sources": [
    {
      "first_seen": "2026-11-11T12:22:28Z",
      "native_id": "PMC13745026",
      "source": "pmc",
      "url": "https://doi.org/10.1161/jaha.125.048758"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Achievement of the American Heart Association Life's Essential 8 Goals With Death Among American Indian People: The Strong Heart Family Study",
  "title_text": "Achievement of the American Heart Association Life's Essential 8 Goals With Death Among American Indian People: The Strong Heart Family Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-12T12:21:25Z",
  "url": "https://research.draconitic.com/paper/cy2xx4vd39ds0",
  "venue": "Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease",
  "versions": []
}