BMC Public Health (Jul 2025)

Association between life’s crucial 9 and major eye diseases among US adults aged 40 years or older

  • Yang Meng,
  • Zongbiao Tan,
  • Yuan Liu,
  • Yuan Ma,
  • Ziye Chen,
  • Lan Jiang,
  • Tao Li

DOI
https://doi.org/10.1186/s12889-025-23704-1
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 10

Abstract

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Abstract Background Vision impairment due to eye diseases represents a significant global public health concern. There is an increasing acknowledgment of the relationship between cardiovascular health (CVH) and eye diseases. However, Life’s Crucial 9 (LC9), the latest scoring framework for CVH, has yet to be investigated in relation to major eye diseases. Methods This cross-sectional study included 3830 adults aged 40 years or older from the US National Health and Nutrition Examination Survey 2005–2008. We analyzed the relationship between LC9 scores and major eye diseases, including retinopathy, age-related macular degeneration, cataract, and glaucoma using weighted multivariable logistic regression, restricted cubic spline analysis, and subgroup analyses. Results After adjusting for covariates, the poor CVH group (LC9 < 50) exhibited significant higher risks of glaucoma (odds ratio [OR] = 2.37, 95% confidence interval [CI]: 1.11–5.08), retinopathy (OR = 2.92, 95% CI: 1.84–4.63), and any objectively confirmed ocular disease (OR = 2.25, 95% CI: 1.45–3.49) compared to the ideal CVH group (LC9 ≥ 80). Restricted cubic spline analysis demonstrated a significant inverse linear association between LC9 scores and the risk of these diseases. Subgroup analyses indicated significant interactions between LC9 score and sex concerning retinopathy and any objectively confirmed ocular disease. Conclusions Suboptimal CVH correlated with increased odds of several major eye diseases in adults aged 40 years or older, highlighting the potential value of CVH optimization for reducing visual impairment burden in this population. Further investigation on the potential causality is warranted.

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