Dual-trajectories of Systolic Blood Pressure and Modified Life’s Essential 8 With Gastrointestinal Cancer and All-Cause Mortality - A Prospective Cohort Study

Sep 22, 2026

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This study aimed to describe joint longitudinal patterns of SBP and modified Life’s Essential 8 (LE8) and to investigate their associations with risks of gastrointestinal cancer and all-cause mortality in the Kailuan Study. SBP trajectories were modeled jointly with a modified LE8 score calculated as the mean of 7 component scores excluding blood pressure. A group-based dual-trajectories model identified five patterns from 2006/2007 to 2014/2015, with Cox regression estimating hazard ratios and 95% confidence intervals.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

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Abstract

Study Aim and Design

Trajectory Modeling and Outcomes

Key Findings and Implications

The Journal of Clinical Hypertension ORIGINAL ARTICLE Dual-trajectories of Systolic Blood Pressure and Modified Life’s Essential 8 With Gastrointestinal Cancer and All-Cause Mortality: A Prospective Cohort Study Heng Yu1, 2 Qian Liu1, 2 Shouling Wu3 Jing Yu1, 2 1 Hypertension Center, The Second Hospital of Lanzhou University, Lanzhou, China 2The Second Clinical Medical School, Lanzhou University, Lanzhou, China 3 Department of Cardiology, Kailuan General Hospital, Tangshan, China Correspondence: Shouling Wu ([drwusl@163.com](drwusl@163.com)) Jing Yu (ery_jyu@lzu.edu.cn) Received: 3 March 2026 Revised: 26 April 2026 Accepted: 6 May 2026 Keywords: all-cause mortality | cancer | Life’s Essential 8 | Systolic blood pressure ABSTRACT This study aimed to describe joint longitudinal patterns of SBP and modified Life’s Essential 8 (LE8) and to further investigate their associations with risks of gastrointestinal cancer and all-cause mortality in the Kailuan Study. Since systolic blood pressure (SBP) was used to assess the dual-trajectories, modified LE8 score was calculated as the average of 7 component score after excluding blood pressure. A group-based dual-trajectories model was used to characterize joint longitudinal patterns of SBP and modified LE8 using data from 2006/2007 to 2014/2015 survey. Multivariable Cox proportional hazards regression models were used to assess associations of dual-trajectories patterns with risks of gastrointestinal cancer and all-cause mortality (hazard ratio, HR and 95% confidence interval, 95% CI). A total of 48,596 participants were included in the current analysis, and five dual-trajectories groups were identified. Compared with group 3, group 2 had the highest risk of gastrointestinal cancer (HR, 1.64; 95% CI, 1.17–2.29), followed by group 4 and group 5, whereas group 1 had the lowest risk of gastrointestinal cancer (HR, 1.09; 95% CI, 0.78–1.51) . Similar results were observed for associations between dual-trajectories of SBP and modified LE8 and all-cause mortality. This study found joint longitudinal patterns of SBP and modified LE8 and revealed their associations with the risks of gastrointestinal cancer and allcause mortality. The findings suggest that individuals with lower modified LE8 scores had higher risks of gastrointestinal cancer and all-cause mortality even at similar SBP levels, underscoring the importance of comprehensive cardiovascular health for risk stratification and prevention. 1 Introduction With population aging, widespread unhealthy lifestyles, and the insidious onset of disease, the burden of gastrointestinal cancers has been increasing [1] . As a major public health challenge, effective cancer prevention is essential for reducing mortality and prolonging life expectancy. Emerging evidence suggests that elevated systolic blood pressure (SBP) or hypertension may be associated with an increased risk of gastrointestinal cancer, whereas the association between diastolic blood pressure (DBP) and gas- Abbreviations: 95% CI, 95% confidence interval; AHA, American Heart Association; AvePP, average posterior probability; BIC, Bayesian Information Criterion; BMI, body mass index; CVD, cardiovascular disease; CVH, cardiovascular health; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; FBG, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol; HR, hazard ratio; hs-CRP, high-sensitivity C-reactive protein; ICD-10International Classification of Disease, International Classification of Disease10th version; LDL-C, low-density lipoprotein cholesterol; LE8, Life’s Essential 8; LS7, Life’s Simple 7; non-HDL-C, non-high-density lipoprotein cholesterol; SBP, systolic blood pressure; SD, standard deviation; TC, total cholesterol; TG, triglycerides.. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, pro

FAQs

How were SBP and modified LE8 jointly analyzed in this study?

The study used a group-based dual-trajectories model to characterize joint longitudinal patterns of systolic blood pressure (SBP) and modified Life’s Essential 8 (LE8) across multiple survey waves.

How was the modified LE8 score calculated?

The modified LE8 score was calculated as the average of 7 component scores after excluding blood pressure.

What was the relationship between trajectory groups and gastrointestinal cancer risk?

Compared with group 3, group 2 showed the highest gastrointestinal cancer risk (HR 1.64; 95% CI 1.17–2.29), while group 1 had the lowest risk (HR 1.09; 95% CI 0.78–1.51).

What do the findings suggest about comprehensive cardiovascular health?

Lower modified LE8 scores were associated with higher risks of gastrointestinal cancer and all-cause mortality even at similar SBP levels, emphasizing comprehensive cardiovascular health for risk stratification and prevention.

Sep 22, 2026

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