Life's Essential 8 and risks of mortality and cardiovascular morbidity in individuals with PRISm and its associations with transition trajectories of PRISm.

Summary

In 31,943 UK Biobank participants with PRISm, lower Life’s Essential 8 (LE8) scores were associated with higher risks of cardiovascular morbidity and all-cause, cardiovascular, and respiratory mortality. Lower LE8 also increased the odds of transitioning from normal spirometry to PRISm and decreased the odds of recovery from PRISm to normal spirometry.

Key Findings

• Among PRISm participants, low LE8 (vs high) was associated with higher cardiovascular disease risk (HR 2.70) and increased all-cause, cardiovascular, and respiratory mortality.
• Low LE8 increased the odds of transitioning from normal spirometry to PRISm (OR 2.24) and reduced the odds of transitioning from PRISm to normal spirometry (OR 0.51).
• Most PRISm individuals fell into the moderate LE8 category, highlighting broad opportunities for health optimization.

Clinical Implications

Incorporating LE8 into PRISm risk stratification could guide targeted lifestyle and preventive strategies to reduce mortality and unfavorable transitions; supports multidisciplinary management.

Limitations

• Observational design limits causal inference; residual confounding possible
• Generalizability may be bounded to UK Biobank demographics

Future Directions

Interventional trials testing LE8-based lifestyle programs in PRISm; mechanistic studies linking LE8 domains to lung structure/function and inflammation.