Association of Life's Essential 8 and psoriasis-atherosclerotic cardiovascular disease (PSO-ASCVD) comorbidity: a prospective cohort study

Abstract

Psoriasis-related cardiovascular comorbidity has gained increasing public attention. The Life’s Essential 8 (LE8) score is a new metric to measure cardiovascular health (CVH), where a higher score suggests better CVH. However, the longitudinal association between LE8 score and the risk of psoriasis-atherosclerotic cardiovascular disease (PSO-ASCVD) comorbidity remains uncertain. This study aims to evaluate the effect of LE8, a comprehensive CVH metric from the American Heart Association, on the risk of PSO-ASCVD Comorbidity. This cohort study included 129,783 participants in the UK Biobank without psoriasis or atherosclerotic cardiovascular disease (ASCVD) at baseline. LE8 comprises eight indicators: diet, physical activity, nicotine exposure, sleep, body mass index (BMI), blood lipid, blood glucose and blood pressure. Multivariable Cox proportional hazards models, along with Cox models incorporating restricted cubic splines (RCS) function, were employed to examine both linear and non-linear associations between LE8 scores and the risk of PSO-ASCVD. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. During an average follow-up of 13.49 years, 151 participants developed PSO-ASCVD. Compared with participants with low LE8 scores, the HRs of developing PSO-ASCVD for those with medium and high LE8 scores were 0.356 (95% CI 0.165-0.767) and 0.242 (95% CI 0.102-0.578) after adjustments, respectively. RCS regression revealed a linear association between LE8 score and PSO-ASCVD risk (P for nonlinearity > 0.05). Among individual LE8 metrics, biological components (glucose, BMI) and behavioral domains (diet, activity, sleep, nicotine) were the major contributors to reduced PSO-ASCVD risk. Higher LE8 scores were correlated with a lower risk of PSO-ASCVD. Maintaining good CVH status is recommended to prevent PSO-ASCVD comorbidity.graphic abstract