Maintaining ideal cardiovascular health is associated with higher serum anti-aging protein klotho in the middle-aged and older populations

OBJECTIVES: Maintaining ideal cardiovascular health (CVH) is believed to have potential anti-aging benefits. The American Heart Association (AHA) recently updated the "Life's Essential 8 (LE8)" metrics to measure ideal CVH, but its connection with the anti-aging protein klotho is still unclear. We aimed to explore the relationship between ideal cardiovascular health and serum anti-aging protein klotho in a nationally representative US middle-aged and older population. DESIGN: A cross-sectional study. SETTING: The National Health and Nutrition Examination Survey (2007-2016). PARTICIPANTS: A total of 9457 middle-aged and older participants. MEASUREMENTS: Ideal CVH scores and their components were defined according to the guidelines set by the AHA. Serum klotho detected by enzyme-linked immunosorbent assay. Weighted multivariable linear regression and restricted cubic spline were employed to examine the association between CVH score and klotho. Subgroup analyses were conducted, stratified by age (40-59 and 60-79), sex (Male and Female), race (Mexican American, non-Hispanic White, non-Hispanic Black, and Others) and chronic kidney disease (Yes and No) in fully adjusted models. RESULTS: A total of 9457 middle-aged and older participants were included in this study, with a mean age of 55.27 ± 0.17 years. The mean serum klotho level in the population was 849.33 ± 5.39 pg/mL. After controlling for potential confounders, the LE8 score showed a positive correlation with serum klotho levels (β: 1.32; 95% CI 0.73, 1.91), and a non-linear dose-response relationship was observed. Furthermore, we also discovered a positive relationship between health behaviors score and health factors score and serum klotho levels (β: 0.48; 95% CI 0.07, 0.88 and β: 1.05; 95% CI 0.54, 1.56, respectively), particularly a stronger correlation between health factors and serum klotho. In the subgroup analysis, we observed a significant interaction between LE8 score and sex and race. (P for interaction <0.05). CONCLUSIONS: LE8 and its subscale scores were positively associated with serum klotho levels in the middle-aged and older populations. Promoting the maintenance of ideal CVH can contribute to delaying the aging process.