The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018

Abstract Objective Chronic respiratory diseases (CRDs) and cardiovascular diseases (CVD) share common risk factors and frequently co-occur, leading to poorer outcomes. Life’s Essential 8 (LE8), a novel metric for cardiovascular health, may provide insights into this association. This study investiga...

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Main Authors: Liu Fen, Li Yan, Zhao Fei, Kuai Zhong-Kai, You Ya-Yu, Hong Xiu-Qin, Wen Si-Ao, Liu Zheng-Yu, Pan Hong-Wei
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03775-x
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author Liu Fen
Li Yan
Zhao Fei
Kuai Zhong-Kai
You Ya-Yu
Hong Xiu-Qin
Wen Si-Ao
Liu Zheng-Yu
Pan Hong-Wei
author_facet Liu Fen
Li Yan
Zhao Fei
Kuai Zhong-Kai
You Ya-Yu
Hong Xiu-Qin
Wen Si-Ao
Liu Zheng-Yu
Pan Hong-Wei
author_sort Liu Fen
collection DOAJ
description Abstract Objective Chronic respiratory diseases (CRDs) and cardiovascular diseases (CVD) share common risk factors and frequently co-occur, leading to poorer outcomes. Life’s Essential 8 (LE8), a novel metric for cardiovascular health, may provide insights into this association. This study investigates the relationship between LE8 and CRDs to identify modifiable factors for targeted prevention. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES), including adults aged 20 years or older. The LE8 score was calculated based on eight indicators: four health behaviors (diet, physical activity, nicotine exposure, and sleep health) and four health factors (body mass index, blood lipids, blood glucose, and blood pressure). CRDs were assessed using a questionnaire-based approach. Multivariable logistic regression and restricted cubic spline models were employed to examine the association between LE8 score and CRDs, adjusting for potential confounders. Subgroup analyses and machine learning models were also conducted. Results Among 20,537 participants included (mean age, 48.02 ± 16.73 years), 10,492 (51.08%) were female and 3812 (18.56%) were determined to have CRDs. The mean LE8 score of the study population was 68.72 ± 14.44. After the adjustment of potential confounders, higher LE8 scores were associated with reduced odds of CRDs (OR:0.77, CI:0.55–0.92), with a nonlinear dose–response relationship observed. A similar pattern was also identified in the association of health factor scores with CRDs, while health behavior showed a linear dose–response relationship with CRDs. Subgroup analyses revealed consistent associations across different ethnicities, education levels, and the presence of cardiovascular disease. Machine learning models identified smoking and LE8 score as the top two factors associated with CRDs. Conclusions This study demonstrates a negative, nonlinear association between LE8 and health factor scores and the presence of CRDs. Our findings suggest that maintaining cardiovascular health, as quantified by the LE8 score, holds potential as a strategic approach for the prevention and management of CRDs.
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spelling doaj-art-90164d2dc3a14002b96d2bcbb34b7ca22025-08-20T03:45:40ZengBMCBMC Pulmonary Medicine1471-24662025-07-0125111110.1186/s12890-025-03775-xThe association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018Liu Fen0Li Yan1Zhao Fei2Kuai Zhong-Kai3You Ya-Yu4Hong Xiu-Qin5Wen Si-Ao6Liu Zheng-Yu7Pan Hong-Wei8Cardiology Department, Hunan Provincial People’s HospitalCardiology Department, Hunan Provincial People’s HospitalRespiratory Department, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital)Respiratory Department, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital)Cardiology Department, Hunan Provincial People’s HospitalCardiology Department, Hunan Provincial People’s HospitalCardiology Department, Hunan Provincial People’s HospitalCardiology Department, Hunan Provincial People’s HospitalCardiology Department, Hunan Provincial People’s HospitalAbstract Objective Chronic respiratory diseases (CRDs) and cardiovascular diseases (CVD) share common risk factors and frequently co-occur, leading to poorer outcomes. Life’s Essential 8 (LE8), a novel metric for cardiovascular health, may provide insights into this association. This study investigates the relationship between LE8 and CRDs to identify modifiable factors for targeted prevention. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES), including adults aged 20 years or older. The LE8 score was calculated based on eight indicators: four health behaviors (diet, physical activity, nicotine exposure, and sleep health) and four health factors (body mass index, blood lipids, blood glucose, and blood pressure). CRDs were assessed using a questionnaire-based approach. Multivariable logistic regression and restricted cubic spline models were employed to examine the association between LE8 score and CRDs, adjusting for potential confounders. Subgroup analyses and machine learning models were also conducted. Results Among 20,537 participants included (mean age, 48.02 ± 16.73 years), 10,492 (51.08%) were female and 3812 (18.56%) were determined to have CRDs. The mean LE8 score of the study population was 68.72 ± 14.44. After the adjustment of potential confounders, higher LE8 scores were associated with reduced odds of CRDs (OR:0.77, CI:0.55–0.92), with a nonlinear dose–response relationship observed. A similar pattern was also identified in the association of health factor scores with CRDs, while health behavior showed a linear dose–response relationship with CRDs. Subgroup analyses revealed consistent associations across different ethnicities, education levels, and the presence of cardiovascular disease. Machine learning models identified smoking and LE8 score as the top two factors associated with CRDs. Conclusions This study demonstrates a negative, nonlinear association between LE8 and health factor scores and the presence of CRDs. Our findings suggest that maintaining cardiovascular health, as quantified by the LE8 score, holds potential as a strategic approach for the prevention and management of CRDs.https://doi.org/10.1186/s12890-025-03775-xChronic respiratory diseasesLife’s Essential 8National Health and Nutrition Examination SurveyLogistic regression
spellingShingle Liu Fen
Li Yan
Zhao Fei
Kuai Zhong-Kai
You Ya-Yu
Hong Xiu-Qin
Wen Si-Ao
Liu Zheng-Yu
Pan Hong-Wei
The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018
BMC Pulmonary Medicine
Chronic respiratory diseases
Life’s Essential 8
National Health and Nutrition Examination Survey
Logistic regression
title The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018
title_full The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018
title_fullStr The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018
title_full_unstemmed The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018
title_short The association of life’s essential 8 with prevalence of chronic respiratory diseases in adults: insights from NHANES 2007–2018
title_sort association of life s essential 8 with prevalence of chronic respiratory diseases in adults insights from nhanes 2007 2018
topic Chronic respiratory diseases
Life’s Essential 8
National Health and Nutrition Examination Survey
Logistic regression
url https://doi.org/10.1186/s12890-025-03775-x
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