ArticleBMJ open respiratory research2026
Association of life's essential 8 with chronic respiratory disease mortality and lung health: a national cohort study.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aims to evaluate the association of Life's Essential 8 (LE8) with chronic lower respiratory disease (CLRD)-specific mortality and impaired lung health outcomes.
methodsThis population-based cohort study used data from the National Health and Nutrition Examination Survey (NHANES, 2007-2018), including adults aged 20-79 years (n=10 135), with lung function measurements available for a subset (n=3188). Multivariable Cox proportional hazards and restricted cubic spline models were employed to assess the associations between LE8 scores and CLRD-specific mortality. Logistic and linear regression models evaluated the associations between LE8 scores and lung health. All models were adjusted for sociodemographic variables (age, sex, race/ethnicity, education, income-to-poverty ratio), cardiovascular disease, respiratory disease and smoking history. Sensitivity analyses were conducted to assess the stability of the results. The primary outcome was CLRD-specific mortality, and the secondary outcome was lung health.
resultsOver a median follow-up of 7.83 years, 50 CLRD-specific deaths were recorded. Higher LE8 scores were associated with reduced risks of CLRD-specific mortality (adjusted HR (aHR), 0.56 (0.40-0.79)), with a linear dose-response relationship observed (P for non-linear=0.574). Furthermore, each 10-point increase in total LE8 score was associated with impaired lung health, including lower odds of asthma (adjusted OR (aOR), 0.88 (0.83-0.93)), chronic bronchitis (aOR, 0.81 (0.74-0.88)), emphysema (aOR, 0.59 (0.52-0.65)), chronic obstructive pulmonary disease (aOR, 0.63 (0.45-0.89)) and lower relative risk of a restrictive spirometry pattern (adjusted relative risk ratio (aRRR), 0.66 (0.56-0.79)). Positive correlations were observed between total LE8 scores and lung function (p<0.001). The findings were robust in sensitivity analyses and consistent across key subgroups.
conclusionsHigher LE8 scores were associated with reduced CLRD-specific mortality and improved lung health. Promoting LE8 adherence could significantly alleviate respiratory disease burdens and mortality.
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