Key Takeaways
Extended Takeaways
- Suicide mortality increased stepwise across cardiovascular health strata, with rates of 0.13, 0.30, and 0.47 per 1,000 person-years in the ideal, intermediate, and poor LE8 groups, respectively; the overall rate was 0.28 per 1,000 person-years.
- The signal appeared to be driven more by modifiable behaviors than by biometric risk factors: poor health behavior scores were associated with a 2.59 times higher risk of suicide mortality (95% CI: 1.23–5.44), while biometric health factor scores showed no clear association.
- Among individual LE8 components, nicotine exposure had the clearest inverse association with suicide mortality (HR: 0.91, 95% CI: 0.86–0.96), suggesting smoking-related measures may be especially informative when evaluating suicide risk alongside general health.
- BMI was the only individual component associated with higher suicide mortality in the adjusted model (HR: 1.10, 95% CI: 1.02–1.18), a reminder that the relationship between weight status and suicide risk may not parallel the direction of the overall composite cardiovascular health score.
- The association was robust across multiple sensitivity analyses, with hazard ratios for poor versus ideal LE8 of 2.48 (1.03–5.96) in competing risk analysis, 4.02 (1.35–11.98) after excluding deaths within 3 years, and 2.33 (1.04–5.21) with multiple imputation.
- Age modified the association: for each 10-point increment in LE8 score, the HR for suicidal mortality was 0.70 (0.57–0.86) in those aged <50 years versus 1.08 (0.87–1.34) in those aged ≥50 years, with an interaction P value of .014.
