Achievement of the American Heart Association Life's Essential 8 Goals With Death Among American Indian People: The Strong Heart Family Study
6 affiliations
- 1Department of Epidemiology University of Washington Seattle WA USA
- 2University of Oklahoma Health Sciences Center Oklahoma City OK USA
- 3Department of Medicine University of Washington Seattle WA USA
- 4MedStar Health Research Institute Washington DC USA
- 5Department of Pediatrics University of Washington Seattle WA USA
- 6Department of Family Medicine University of California San Diego San Diego CA USA
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.
Methods: 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).
Results: 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.
Conclusions: 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.
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BibTeX
@article{paing2026achievement,
title = {{Achievement of the American Heart Association Life's Essential 8 Goals With Death Among American Indian People: The Strong Heart Family Study}},
author = {Pyone Yadanar Paing and Jessica A. Reese and Colleen M. Sitlani and Ying Zhang and Jason G. Umans and Reya Mokiao and Matthew Allison and Amanda M. Fretts},
journal = {Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease},
year = {2026},
month = sep,
doi = {10.1161/jaha.125.048758},
url = {https://doi.org/10.1161/jaha.125.048758},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Achievement of the American Heart Association Life's Essential 8 Goals With Death Among American Indian People: The Strong Heart Family Study
AU - Pyone Yadanar Paing
AU - Jessica A. Reese
AU - Colleen M. Sitlani
AU - Ying Zhang
AU - Jason G. Umans
AU - Reya Mokiao
AU - Matthew Allison
AU - Amanda M. Fretts
PY - 2026
DA - 2026/09/24
JO - Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
DO - 10.1161/jaha.125.048758
UR - https://doi.org/10.1161/jaha.125.048758
AB - 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. Methods: 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). Results: 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. Conclusions: 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.
SN - 2047-9980
ER -