# Sustained high Life’s Essential 8 is associated with lower risk of cerebral small vessel disease: a community-based study

## TL;DR

Maintaining high Life’s Essential 8 scores is linked to a lower risk of cerebral small vessel disease in a community-based study.

## Contribution

This study shows that long-term adherence to Life’s Essential 8 reduces the risk of cerebral small vessel disease.

## Key findings

- Sustained high LE8 scores are associated with a significantly lower risk of cerebral small vessel disease.
- LE8 has the strongest protective effect on lacunar infarcts, enlarged perivascular spaces, and white matter hyperintensities.
- No significant association was found between LE8 and cerebral microbleeds.

## Abstract

We aimed to investigate the influence of Life’s Essential 8 (LE8) score trajectories on cerebral small vessel disease (CSVD).

A total of 1,162 subjects from the Kailuan prospective cohort study were enrolled. The LE8 score trajectories were developed from 2006 to 2021 using trajectory modeling of the SAS procedure Proc Traj. Participants were classified into three trajectory models: low stable group, medium stable group, and high stable group. Magnetic resonance imaging (MRI) was performed at the last follow-up. Ordered logistic regression and binary logistic regression models were employed to analyze the association between LE8 trajectory groups and the total CSVD score. Furthermore, we examined the relationship between LE8 trajectory groups and Various CSVD Lesions: lacunar infarcts, cerebral microbleeds (CMB), white matter hyperintensities (WMH), and enlarged perivascular spaces (EPVS).

(1) There is a negative association between sustained high LE8 scores and the risk of CSVD. The odds ratios (OR) for an increased risk of elevated CSVD scores in the medium and high stable groups compared to the low stable group were 0.65 (95% CI: 0.47–0.88) and 0.44 (95% CI: 0.30–0.63), both of which were statistically significant. (2) LE8 had the most significant impact on lacunar infarcts, EPVS and WMH. The ORs for an increased risk of lacunar infarcts in the medium and high stable groups compared to the low stable group were 0.56 (95% CI: 0.37–0.86) and 0.25 (95% CI: 0.14–0.47), respectively. The ORs for an increased risk of BG-EPVS were 0.49 (95% CI: 0.30–0.81) and 0.31 (95% CI: 0.18–0.54), respectively. The ORs for an increased risk of WMH were 0.49 (95% CI: 0.64–1.38) and 0.58 (95% CI: 0.36–0.95), respectively. However, LE8 showed no statistically significant impact on CMB.

In summary, our study revealed that sustained high Life’s Essential 8 scores have a protective effect against cerebral small vessel disease.