*: Group differences were analyzed using independent t-tests or ANOVA for normally distributed continuous variables, Mann–Whitney U tests for non-normally distributed variables, and chi-square (χ2) tests for categorical variables. Other-cause death does not include CVD death. CVD: cardiovascular disease.
While preparing this work, the authors used OpenAI and DeepSeek to enhance clarity and readability. After using the tools, the authors reviewed and edited the content as needed and take full responsibility for the publication’s content.
Author contributions
GH: Conceptualization, Supervision, Writing—review & editing. YN: Data curation, Formal analysis, Methodology, Visualization, Writing—original draft. H Zhang, FH, LS, XQ, HX, H Zhu, YD, and HC: Investigation, Validation, Writing—review & editing. All authors contributed to the article and approved the final submitted version.
Conflicts of interest
The authors have nothing to declare.
Ethical approval
The NHANES protocol was approved by the National Center for Health Statistics Research Ethics Review Board (Protocol #98-12, #2005-06, and #2011-17), and the HRS study was approved by the University of Michigan Health Sciences and Behavioral Sciences Institutional Review Board (HUM00061128). Both studies comply with the Declaration of Helsinki, and all participants provided written informed consent.
Consent to participate
Informed consent was obtained from all participants in the original studies.
Consent to publication
Not applicable.
Availability of data and materials
The NHANES and HRS datasets analyzed during the current study are publicly available from the official websites of the National Center for Health Statistics and the Health and Retirement Study program.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
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