Examining the relationship between Life’s Essential 8 and atherosclerotic cardiovascular disease among Adults in the United States: Insights from the National Health and Nutrition Examination Surveys (2017-2020)
The American Heart Association recently updated the assessment of cardiovascular health (CVH) with the Life’s Essential 8 (LE8) score. Our cross-sectional analytical study utilized data from 5042 adults in the United States (US) from the 2017 to 2020 NHANES surveys to examine the relationship between CVH assessed by LE8 metrics and the prevalence of atherosclerotic cardiovascular disease (ASCVD). Multivariate linear regressions were utilized to explore the relationship between CVH metrics and ASCVD, while linear probability models were used to predict ASCVD prevalence based on achieved LE8 scores. Controlling for relevant covariates revealed an inverse association between LE8 metrics and ASCVD prevalence. Improvements in LE8 were linked to a 29% reduction in ASCVD prevalence, with transitions to higher LE8 quartiles predicting a 4.8% reduction in ASCVD prevalence. Subgroup analysis indicated significant effects of age, education, and gender on ASCVD prevalence, with younger age, college education, and the female gender being associated with lower prevalence (P < 0.05). Higher LE8 scores correlated with decreased ASCVD prevalence, while factors such as younger age, college education, and the female gender were also associated with lower ASCVD prevalence. Conversely, transitioning from married to divorced/widowed/separated status was linked to increased ASCVD prevalence (P < 0.01).
- Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and Stroke statistics-2022 update. A report from the American heart association. Circulation. 2022;145:e153-e639. doi: 10.1161/CIR.0000000000001052
- Lin CC, Peyser PA, Kardia SL, et al. Heritability of cardiovascular risk factors in a Chinese population-- taichung community health study and family cohort. Atherosclerosis. 2014;235(2):488-495. doi: 10.1016/j.atherosclerosis.2014.05.939
- Lloyd-Jones DM, Ning H, Labarthe D, et al. Erratum: Status of cardiovascular health in US adults and children using the American heart association’s new “life’s essential 8” metrics: Prevalence estimates from the national health and nutrition examination survey (NHANES), 2013 through 2018. Circulation. 2022;146:822-835. doi: 10.1161/CIRCULATIONAHA.122.060911
- Enyeji AM, Barengo NC, Ibrahimou B, Ramirez G, Arrieta A. Association between Non-Dietary cardiovascular health and expenditures related to acute coronary syndrome in the US between 2008-2018. Int J Environ Res Public Health. 2023;20(9):5743. doi: 10.3390/ijerph20095743
- Brown AF, Liang LJ, Vassar SD, et al. Trends in racial/ethnic and nativity disparities in cardiovascular health among adults without prevalent cardiovascular disease in the United States, 1988 to 2014. Ann Intern Med. 2018;168:541-549. doi: 10.7326/M17-0996
- Stierman B, Afful J, Carroll MD, et al. National Health and Nutrition Examination Survey 2017-March 2020 Prepandemic Data Files-Development of Files and Prevalence Estimates for Selected Health Outcomes. National Health Statistics Reports Series No 158; 2021. doi: 10.15620/cdc:106273
- Chobufo MD, Regner SR, Zeb I, Lacoste JL, Virani SS, Balla S. Burden and predictors of statin use in primary and secondary prevention of atherosclerotic vascular disease in the US: From the National Health and Nutrition Examination Survey 2017-2020. Eur J Prev Cardiol. 2022;29(14):1830-1838. doi: 10.1093/eurjpc/zwac103
- Al Rifai M, Blaha MJ, Nambi V, et al. Determinants of incident atherosclerotic cardiovascular disease events among those with absent coronary artery calcium: Multi-ethnic study of atherosclerosis. Circulation. 2022;145(4):259-267. doi: 10.1161/CIRCULATIONAHA.121.056705
- Jain V, Al Rifai M, Turpin R, et al. Evaluation of factors underlying sex-based disparities in cardiovascular care in adults with self-reported premature atherosclerotic cardiovascular disease. JAMA Cardiol. 2022;7(3):341-345. doi: 10.1001/jamacardio.2021.5430
- Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: Update from the GBD 2019 study. J Am Coll Cardiol. 2020;76(25):2982-3021. doi: 10.1016/j.jacc.2020.11.010
- Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction. The American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4):586-613. doi: 10.1161/CIRCULATIONAHA.109.192703
- Perak AM, Ning H, Khan SS, et al. Associations of late adolescent or young adult cardiovascular health with premature cardiovascular disease and mortality. J Am Coll Cardiol. 2020;76:2695-2707. doi: 10.1016/j.jacc.2020.10.002
- Reedy J, Lerman JL, Krebs-Smith SM, et al. Evaluation of the healthy eating index-2015. J Acad Nutr Diet. 2018;118(9):1622-1633. doi: 10.1016/j.jand.2018.05.019
- Chen W, Shi S, Jiang Y, et al. Association of sarcopenia with ideal cardiovascular health metrics among US adults: A cross-sectional study of NHANES data from 2011 to 2018. BMJ Open. 2022;12(9):e061789. doi: 10.1136/bmjopen-2022-061789
- Shay CM, Ning H, Allen NB, et al. Status of cardiovascular health in US adults: Prevalence estimates from the national health and nutrition examination surveys (NHANES) 2003-2008. Circulation. 2012;125(1):45-56. doi: 10.1161/CIRCULATIONAHA.111.035733
- Leopold JA, Antman EM. Ideal cardiovascular health in young adults with established cardiovascular diseases. Front Cardiovasc Med. 2022;9:814610. doi: 10.3389/fcvm.2022.814610
- Li X, Ma H, Wang X, Feng H, Qi L. Life’s essential 8, genetic susceptibility, and incident cardiovascular disease: A prospective study. Arterioscler Thromb Vasc Biol. 2023;43(7):1324-1333. doi: 10.1161/ATVBAHA.123.319290
- Shah NS, Talegawkar SA, Jin Y, Hussain BM, Kandula NR, Kanaya AM. Cardiovascular health by life’s essential 8 and associations with coronary artery calcium in South Asian American adults in the MASALA study. Am J Cardiol. 2023;199:71-77. doi: 10.1016/j.amjcard.2023.05.004
- Herraiz-Adillo Á, Higueras-Fresnillo S, Ahlqvist VH, et al. Life’s essential 8 and life’s simple 7 in relation to coronary atherosclerosis: Results from the population-based SCAPIS project. Mayo Clin Proc. 2024;99(1):69-80. doi: 10.1016/j.mayocp.2023.03.023
- Jin C, Li J, Liu F, et al. Life’s essential 8 and 10-year and lifetime risk of atherosclerotic cardiovascular disease in China. Am J Prev Med. 2023;64(6):927-935. doi: 10.1016/j.amepre.2023.01.009
- Zhang N, Wei Z, Zhang Y, et al. Association of life’s essential 8 with incident atherosclerotic cardiovascular disease in cancer patients: The Kailuan prospective cohort study. Eur J Prev Cardiol. 2023;30(17):e78-e80. doi: 10.1093/eurjpc/zwad256
- McLaughlin MM, Durstenfeld MS, Gandhi M, et al. Cardiovascular health among persons with HIV without existing atherosclerotic cardiovascular disease. AIDS. 2023;37(14):2179-2183. doi: 10.1097/QAD.0000000000003666
- Olson NC, Cushman M, Judd SE, et al. American heart association’s life’s simple 7 and risk of venous thromboembolism: The reasons for geographic and racial differences in stroke (REGARDS) study. J Am Heart Assoc. 2015;4(3):e001494. doi: 10.1161/JAHA.114.001494
- Uijl A, Koudstaal S, Vaartjes I, et al. Risk for heart failure: The opportunity for prevention with the American heart association’s life’s simple 7. JACC Heart Fail. 2019;7(8):637-647. doi: 10.1016/j.jchf.2019.03.009
- Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic status, education and empowerment: Implications for maternal health service utilization in developing countries. PLoS One. 2010;5(6):e11190. doi: 10.1371/journal.pone.0011190
- Ogunmoroti O, Michos ED, Aronis KN, et al. Life’s simple 7 and the risk of atrial fibrillation: The multi-ethnic study of atherosclerosis. Atherosclerosis. 2018;275:174-181. doi: 10.1016/j.atherosclerosis.2018.05.050
- Douglas PS, McCallum S, Lu MT, et al. Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV. AIDS. 2023;37(3):423-434. doi: 10.1097/QAD.0000000000003418
- Krebs-Smith SM, Pannucci TR, Subar AF, et al. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet. 2018;118(9):1591-1602. doi: 10.1016/j.jand.2018.05.021
- Trivedi T, Liu J, Probst J, Merchant A, Jones S, Martin AB. Obesity and obesity-related behaviors among rural and urban adults in the USA. Rural Remote Health. 2015;15(4):3267. doi: 10.22605/rrh3267
- Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity. A comprehensive review. Circulation. 2016;133(2):187-225. doi: 10.1161/CIRCULATIONAHA.115.018585
- David CJ, Rajapriya R, Veena V, Kumaresan G. High cholesterol diet induces obesity in Zebrafish. Int J Adv Sci Eng. 2016;2(4):197-201.