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Young Adult Heart Health Trajectories Strongly Predict Later Cardiovascular Disease

A JAMA Network Open analysis of 4,241 CARDIA participants links two‑decade Life’s Essential 8 patterns in young adults to later cardiovascular events.

Overview

  • Every 10‑point decrease in Life’s Essential 8 score from baseline to year 20 was associated with a 53% higher risk of subsequent cardiovascular disease (adjusted HR 1.53).
  • Four trajectory groups showed graded risk vs the persistently high group: persistently moderate (aHR 2.15), moderate declining (aHR 5.25) and moderate‑to‑low declining (aHR 9.96).
  • Secondary analyses found lower risk with stable high cardiovascular health vs stable moderate (aHR 0.25) and higher risk with stable low health (aHR 5.91).
  • The cohort included 4,241 Black and White adults aged 18–30 recruited in 1985–86 at four U.S. centers, with outcomes after year 20 including myocardial infarction, heart failure, stroke, coronary revascularization and cardiovascular death.
  • Authors highlight primordial prevention in early adulthood using the American Heart Association’s Life’s Essential 8 metrics, with findings published in October 2025 in JAMA Network Open.