{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:53:06Z","timestamp":1791355986702,"version":"4.3.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The American Heart Association's Life's Essential 8 is a metric used to assess cardiovascular health (CVH) that includes 4 health behaviors and 4 health factors. We examined the association of achievement of Life's Essential 8 with death among American Indian people who participated in the SHFS (Strong Heart Family Study), a study of cardiovascular disease risk factors in 12 rural American Indian communities in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 2230 SHFS participants were included. A composite CVH score (0\u2013100) was created on the basis of the achievement of Life's Essential 8 goals except sleep and categorized into low (0\u201349), moderate (50\u201369), and high (70\u2013100) CVH. Cox proportional hazards models were used to examine the association of CVH with mortality risk (all\u2010cause and cardiovascular disease death).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">There were 555 deaths over a median 19.3\u2010year follow\u2010up. The risk of death from any cause was lower among participants who achieved high CVH (hazard ratio [HR], 0.52 [95% CI, 0.38\u20130.70]) or moderate CVH (HR, 0.67 [95% CI, 0.56\u20130.78]) compared with those with low CVH. Similarly, the risk of death from cardiovascular disease was lower among participants with high CVH (HR, 0.30 [95% CI, 0.14\u20130.67]) or moderate CVH (HR, 0.56 [95% CI, 0.39\u20130.79]) compared with participants with low CVH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher achievement of Life's Essential 8 was associated with lower risk of all\u2010cause and cardiovascular disease death. This work highlights the importance of promoting optimal CVH to minimize risk of death in American Indian communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048758","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:41:28Z","timestamp":1790311288000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Achievement of the American Heart Association Life's Essential 8 Goals With Death Among American Indian People: The Strong Heart Family Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9136-2538","authenticated-orcid":false,"given":"Pyone Yadanar","family":"Paing","sequence":"first","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6640-6543","authenticated-orcid":false,"given":"Jessica A.","family":"Reese","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7656-7482","authenticated-orcid":false,"given":"Colleen M.","family":"Sitlani","sequence":"additional","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6945-3743","authenticated-orcid":false,"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-3350","authenticated-orcid":false,"given":"Jason G.","family":"Umans","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2960-4433","authenticated-orcid":false,"given":"Reya","family":"Mokiao","sequence":"additional","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0777-8272","authenticated-orcid":false,"given":"Matthew","family":"Allison","sequence":"additional","affiliation":[{"name":"University of California San Diego","place":["San Diego, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5358-2345","authenticated-orcid":false,"given":"Amanda M.","family":"Fretts","sequence":"additional","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001078"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02824-8"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.01.021"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1515\/jtim-2023-0119"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-6051.24.05774-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.112032"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1466752"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2024.1465310"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-024-06117-z"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030764"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-023-00793-7"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.11476"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000773"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080973"},{"key":"e_1_3_2_16_2","unstructured":"Center of Disease Control and Prevention National Center for Health Statistics . 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