A large-scale prospective cohort study from researchers in China has found that individuals with healthier cardiovascular profiles – as measured by the American Heart Association’s Life’s Essential 8 (LE8) – are significantly less likely to develop age-related macular degeneration (AMD), even if they are genetically predisposed to the condition.
The study followed 268,634 participants from the UK Biobank over an average of 13.8 years, tracking both their cardiovascular health and incidence of AMD. The LE8 metric combines eight key lifestyle and biological factors: diet, physical activity, sleep, nicotine exposure, body mass index (BMI), blood pressure, blood glucose, and lipid levels. All participants were stratified into low, moderate, or high cardiovascular health based on their LE8 scores.
Findings showed that those with high LE8 scores had a lower risk of developing AMD compared to those with poor cardiovascular health. Even a moderate LE8 score was shown to substantially reduce AMD risk. Importantly, the protective effect was observed across all levels of polygenic risk – a measure of inherited genetic susceptibility – indicating that good lifestyle choices can offset genetic vulnerability.
Sub-analysis revealed that behaviors like physical activity, smoking cessation, and blood glucose control were especially influential. Interestingly, higher blood lipid levels – typically considered a cardiovascular risk – were also associated with a slightly increased risk of AMD in this context. However, dietary quality and sleep duration did not show consistent associations with AMD risk.
The study’s strength lies in its large sample size, long follow-up, and robust sensitivity analyses, including adjustments for sociodemographic and genetic factors, the authors say. The researchers also found that the benefit of high LE8 scores was more pronounced in younger individuals, women, and nondrinkers, emphasizing the importance of early and targeted lifestyle interventions.
