Linking adiposity and inflammation with all-cause and cardiovascular mortality

Life’s Essential 8 (LE8) and Life’s Crucial 9 (LC9) from the American Heart Association are industry-accepted metrics that summarize overall cardiovascular health. A new study documents inverse associations between these indicators and all-cause and cardiovascular mortality in postmenopausal women.

Adiposity and systemic inflammation showed partial statistical mediation of these associations. Results of the study are published online in Menopause in a paper titled “Mediation analysis of adiposity and inflammation in the associations of Life’s Crucial 9 and Life’s Essential 8 with mortality among postmenopausal women.”

Cardiovascular disease remains the leading cause of morbidity and mortality in women worldwide. Due to hormone changes, metabolic alterations, and vascular aging, this risk significantly increases after menopause. Comprehensive assessment of cardiovascular health is therefore essential for identifying high-risk populations and building prevention strategies in postmenopausal women.

Although higher LE8 and LC9 scores have been associated with reduced risks of cardiovascular events and mortality, the underlying causes of these associations have not been completely identified.

Postmenopausal women undergo substantial shifts in body composition and fat redistribution (especially around a woman’s midsection) that elevate cardiometabolic risk. In addition, in this population, higher adiposity is frequently associated with an increased frequency of inflammatory markers and metabolic dysregulation.

A study involving more than 7,800 postmenopausal women (of whom 1,313 had died during follow-up) sought to examine the relationships between LE8 and LC9 and all-cause and cardiovascular mortality and to evaluate whether adiposity-related and inflammation-related indicators statistically mediate these associations.

Based on the results, the researchers concluded that higher LC9 and LE8 scores were associated with lower risks of all-cause and cardiovascular mortality in postmenopausal women. Moreover, adiposity-related and inflammation-related indicators partially mediated these associations.

These findings underscore the importance of comprehensive cardiovascular health assessment and suggest the benefits of maintaining favorable cardiometabolic profiles.

“We already know that lifestyle factors such as diet, exercise, sleep, and not smoking are important for heart health, but the findings of this study highlight just how powerful they may be. Women with better overall cardiometabolic health profiles after menopause are more likely to live longer, suggesting that many of the factors influencing our health span are within our control,” says Dr. Stephanie Faubion, medical director for The Menopause Society.