Cardiovascular health and cancer mortality - evidence from US NHANES and UK Biobank cohort studies - Research article

Sep 21, 2026

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Background discusses the American Heart Association Life’s Essential 8 (LE8) cardiovascular health metric and the uncertainty about how LE8 relates to cancer mortality risk. Methods analyze cancer-free participants from US NHANES (17,076) and UK Biobank (272,727) using LE8-based cardiovascular health scores covering four behaviors and four health factors, with Cox models adjusting for covariates. Results report lower overall cancer mortality with high CVH in both cohorts, dose-response reductions per one standard deviation, subtype-specific decreases, and an interaction assessment with cancer-related polygenic risk scores. Conclusions indicate optimal CVH substantially lowers cancer mortality and may benefit individuals with high genetic predisposition.

LanguageEnglish

CategoryResearch & Report

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Pages16

Reading Time40 min

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Abstract

Background

Methods

Results

Conclusions

Background

Lin etal. BMC Medicine (2024) 22:368 [https://doi.org/10.1186/s12916-024-03553-2](https://doi.org/10.1186/s12916-024-03553-2) BMC Medicine RESEARCH ARTICLE Open Access Cardiovascular health and cancer mortality: evidence from US NHANES and UK Biobank cohort studies Lijin Lin1,2†, Yulian Hu3,4†, Fang Lei2,5, Xuewei Huang2,6, Xingyuan Zhang2,7, Tao Sun1,2, Weifang Liu 1,2, Ru Li 1,2, Xiao-Jing Zhang2,7, Jingjing Cai2,6, Zhi-Gang She1,2*, Guoping Wang4,8* and Hongliang Li 1,2,4,5,9* Abstract Background The American Heart Association recently introduced a novel cardiovascular health (CVH) metric, Life’s Essential 8 (LE8), for health promotion. However, the relationship between LE8 and cancer mortality risk remains uncertain. Methods We investigated 17,076 participants from US National Health and Nutrition Examination Survey (US NHANES) and 272,727 participants from UK Biobank, all free of cancer at baseline. The CVH score, based on LE8 metrics, incorporates four health behaviors (diet, physical activity, smoking, and sleep) and four health factors (body mass index, lipid, blood glucose, and blood pressure) . Self-reported questionnaires assessed health behaviors. Primary outcomes were mortality rates for total cancer and its subtypes. The association between CVH score (continuous and categorical variable) and outcomes was examined using Cox model with adjustments. Cancer subtypes-related polygenic risk score (PRS) was constructed to evaluate its interactions with CVH on cancer death risk. Results Over 141,526 person-years in US NHANES, 424 cancer-related deaths occurred, and in UK Biobank, 8,872 cancer deaths were documented during 3,690,893 person-years. High CVH was associated with reduced overall cancer mortality compared to low CVH (HR 0 . 58, 95% CI 0.37–0.91 in US NHANES; 0 . 51, 0.46–0.57 in UK Biobank) . Each one-standard deviation increase in CVH score was linked to a 19% decrease in cancer mortality (HR: 0 . 81; 95% CI: 0 .73–0. 91) in US NHANES and a 19% decrease (HR: 0 . 81; 95% CI: 0 .79–0. 83) in UK Biobank. Adhering to ideal CVH was linearly associated with decreased risks of death from lung, bladder, liver, kidney, esophageal, breast, colorectal, pancreatic, and gastric cancers in UK Biobank. Furthermore, integrating genetic data revealed individuals with low PRSand high CVH exhibited the lowest mortality from eight cancers (HRs ranged from 0.36 to 0 . 57) compared to those with high PRS and low CVH. No significant modification of the association between CVH and mortality risk for eight cancers by genetic predisposition was observed. Subgroup analyses showed a more pronounced protective association for overall cancer mortality among younger participants and those with lower socio-economic status. † Lijin Lin and Yulian Hu contributed equally to this work. *Correspondence: Zhi-Gang She [zgshe@whu.edu.cn](zgshe@whu.edu.cn)[ ](zgshe@whu.edu.cn)Guoping Wang [wangguoping@hgyy.org.cn](wangguoping@hgyy.org.cn)[ ](wangguoping@hgyy.org.cn)Hongliang Li[lihl@whu.edu.cn](lihl@whu.edu.cn) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation

FAQs

What cardiovascular health metric is evaluated in relation to cancer mortality?

The study evaluates the American Heart Association’s Life’s Essential 8 (LE8) cardiovascular health metric. LE8 is used to derive a cardiovascular health (CVH) score from multiple behaviors and health factors.

How were participants and outcomes defined in the analysis?

Participants were cancer-free at baseline and came from US NHANES and UK Biobank cohorts. Outcomes included total cancer mortality and cancer subtype-specific mortality.

What is the key finding about CVH and cancer mortality?

High CVH is associated with reduced overall cancer mortality in both cohorts, with an additional dose-response pattern per one standard deviation increase in CVH score. Ideal CVH also correlates with lower mortality across multiple cancer subtypes.

Sep 21, 2026

Uploaded by Theodore