Hypertension is a major cardiovascular disease. The relationship between Life's Essential 8 (LE8) score, a newly developed cardiovascular health metric, and hypertension risk remains unclear.

This study aimed to investigate the association between LE8 score and hypertension risk in the rural and pastoral population of Altay Prefecture, Xinjiang.

From October to November 2023, 27 natural villages were selected in Altay Prefecture using Proportionate to Population Size (PPS) systematic sampling. Eligible residents in the included natural villages were recruited for questionnaire surveys, physical examinations, and laboratory index tests. The LE8 score includes 4 health behaviors (diet, physical activity, nicotine exposure, sleep) and 4 health factors (BMI, blood lipids, blood glucose, blood pressure). In this study, the LE8 score was calculated based on the remaining 7 components excluding blood pressure. The LE8 score, subscales and components were divided into low group (0-49 points), medium group (50-79 points) and high group (80-100 points) according to their scores. A restrictive cubic spline plot was used to plot the dose-response curves of LE8, health factors and health behavior scores and hypertension. A multivariate logistic regression model was used to analyze its effect on the prevalence of hypertension.

A total of 2 872 study subjects were included in this study. Among the study subjects, 1 540 patients with hypertension were detected, yielding a crude prevalence of 53.62% and an age-standardized prevalence of 34.64%. The prevalence of hypertension was 61.13% in men (766/1 253) and 47.81% (774/1 619) in women, and the prevalence of hypertension in men was higher than that in women (P<0.05). In terms of LE8 score, the difference between the hypertensive group and the normal blood pressure group was statistically significant (P<0.05). After adjusting for confounders, the intermediate and high LE8 score groups had a lower risk of hypertension compared with the low score group (P<0.05). For every 10-point increase in LE8 score, the risk of hypertension decreased by 24.3% and 41.8%, respectively. A significant non-linear relationship was observed between LE8 scores and hypertension (P_{for non-linear}=0.010), while a linear relationship was found between health factor scores and hypertension (P_{for non-linear}=0.637). No significant association was observed between health behavior scores and hypertension (P>0.05). Participants with higher BMI, blood glucose, and physical activity scores had a significantly lower risk of hypertension compared to the low-score group (P<0.05). An interaction between LE8 scores and age was detected (P_{for interaction}<0.05), with a stronger effect of LE8 scores on reducing hypertension risk in individuals aged >50 years (P<0.05).

LE8 scores are non-linearly associated with hypertension risk. Maintaining higher LE8 scores can reduce the burden of hypertension, particularly in individuals aged ≥50 years.

高血压是主要的心血管疾病，"生命八要素"（LE8）评分作为近期提出的心血管健康评价指标，与高血压患病风险之间的关系尚不明确。

探讨新疆阿勒泰地区农牧区人群LE8评分与高血压患病风险之间的关系。

于2023年10—11月，依据人口规模成比例系统抽样（PPS）在新疆阿勒泰地区抽取27个自然村，在纳入的自然村中招募符合研究要求的居民进行问卷调查、体格检查及实验室指标检测。LE8评分包括4个健康行为（饮食、体力活动、尼古丁暴露、睡眠）和4个健康因素（BMI、血脂、血糖、血压），本研究以除血压外的其余7个组分计算LE8评分。LE8评分、健康行为和健康因素子量表评分、7个组分评分均被划分为3组：低分组（0~49分）、中等分组（50~79分）及高分组（80~100分）。采用限制性立方样条图绘制LE8评分与高血压患病的剂量-反应曲线，采用Logistic回归模型分析LE8评分对高血压患病的影响。

本研究共纳入2 872名居民，检出高血压患者1 540名，高血压粗患病率为53.62%，标准化患病率为34.64%。其中，男性高血压患病率为61.13%（766/1 253），女性高血压患病率为47.81%（774/1 619），男性高血压患病率高于女性（P<0.05）。是否患高血压居民的LE8评分比较，差异有统计学意义（P<0.05）。在调整混杂因素后，与低分组比较，LE8评分、健康因素评分中等分组和高分组的高血压患病风险降低（P<0.05），且每增加10分，高血压患病风险分别降低24.3%和41.8%（P<0.05）。LE8评分与高血压患病风险之间存在明显非线性关系（P_非线性=0.010），健康因素评分与高血压患病之间呈线性关系（P_非线性=0.637），未发现健康行为评分与高血压患病之间的明显关联（P>0.05）。BMI、血糖水平、体力活动评分高分组的高血压患病风险较低分组低（P<0.05）。LE8评分与年龄在高血压患病中存在交互作用（P_交互<0.05），对于50岁以上的人群，LE8评分对降低高血压患病风险的作用更加明显（P<0.05）。

LE8评分与高血压患病风险呈非线性相关，保持较高的LE8评分可降低高血压疾病负担。