美国心脏协会的 Life's Essential 8 (LE8) 总统建议认为心理健康是心血管健康 (CVH) 的基础，但并未将其作为 CVH 指标。本研究的目的是评估第九个指标增强的 CVH 结构之间的关联基于易于管理的美国成年人死亡风险抑郁症筛查的心理健康。参与者为 2011 年至 2018 年国家卫生和计划生育委员会的 21,183 名成年人（平均年龄：48 岁，51% 女性，11% 黑人，15% 西班牙裔，65% 白人）。营养检查调查。 LE8算法用于评估CVH。计算了两个增强的 CVH 构造，其中包括基于使用患者健康问卷（PHQ-2 和 PHQ-9）进行抑郁症筛查的第九个心理健康指标。多变量 Cox 比例风险模型比较了整个样本中 CVH 评分三分位数和先验定义类别（高：80-100，中：50-79，低：0-49）的全因和特定原因死亡风险，并按性别分类共有 1,397 人死亡（414 人死于心血管疾病，329 人死于癌症）。高与低 CVH 评分（通过 PHQ-2 和 PHQ-9 增强）与死亡风险降低 69% 和 70% 相关，而高与低 LE8 评分与风险降低 65% 相关（p 趋势<0.001）。较高的 LE8 和较高的 CVH 分数预示着男女、黑人和白人的死亡风险较低，但西班牙裔成年人则不然，并且还与较低的心血管和癌症死亡率相关。两种增强的 CVH 评分在预测死亡率方面都有出色的表现，与 LE8 评分相似（C 统计 = 0.843 vs 0.842，P < 0.001）。通过心理健康增强的 CVH 构建可以强烈预测死亡率。应考虑将心理健康作为第九个 CVH 指标，并将抑郁症筛查作为临床和公共卫生环境中的可行指标。© 2024 作者。

The American Heart Association's Life's Essential 8 (LE8) Presidential Advisory deemed psychological health foundational for cardiovascular health (CVH) but did not include it as a CVH metric.The purpose of this study was to evaluate associations of a CVH construct enhanced with a ninth metric for psychological health based on readily administered depression screening with mortality risk in U.S. adults.Participants were 21,183 adults (mean age: 48y, 51% female, 11% Black, 15% Hispanic, 65% White) from the 2011 to 2018 National Health and Nutrition Examination Survey. The LE8 algorithm was used to assess CVH. Two enhanced CVH constructs that include a ninth psychological health metric based on depression screening using the Patient Health Questionnaires (PHQ-2 and PHQ-9) were computed. Multivariable Cox proportional hazards models compared all-cause and cause-specific mortality risk across CVH score tertiles and a priori defined categories (high: 80-100, moderate: 50-79, low: 0-49) in the overall sample and by sex and race and ethnicity.There were 1,397 deaths (414 cardiovascular and 329 cancer deaths). High vs low CVH scores, enhanced with PHQ-2 and PHQ-9, were associated with 69% and 70% lower mortality risk, while a high vs low LE8 score was associated with 65% lower risk (p-trend<0.001). Higher LE8 and enhanced CVH scores predicted lower mortality risk in both sexes and in Black and White but not Hispanic adults and were also associated with lower cardiovascular and cancer mortality. Both enhanced CVH scores had excellent performance for predicting mortality, similar to the LE8 score (C-statistic = 0.843 vs 0.842, P < 0.001).A CVH construct enhanced with psychological health strongly predicts mortality. Inclusion of psychological health as a ninth CVH metric, with depression screening as a feasible proxy in clinical and public health settings, should be considered.© 2024 The Authors.