Abstract 15482: Trends in Cardiovascular Health Among Older Adults With and Without Cardiovascular Diseases: National Health and Nutrition Examination Survey (NHANES), 2013-2018

Abstract

Introduction: American Heart Association’s (AHA) Life’s Essential 8 (LE8) is a framework for quantifying cardiovascular health (CVH). Prior studies have focused on individuals without clinical cardiovascular disease (CVD). We sought to examine recent trends in LE8 scores among older adults with prevalent CVD. Methods: We included non-institutionalized older US adults (ages 65+) from NHANES (2013-18). Overall LE8 scores (range 0-100; higher = better CVH) were calculated for all participants with or without CVD, using methods recommended by the AHA. CVD diagnoses were self-reported, including coronary heart disease (CHD), stroke, heart failure (HF), hypertension (HTN), angina, and myocardial infarction (MI). Percent change in LE8 scores from 2013-18 was calculated for each diagnosis group, and a linear regression tested for significance of changes within groups. Results: The 3,050 participants represented 37,908,305 adults (54.7% women; mean age 72.6 y); 3.4% self-identified as Asian, 7.2% Black, 3.9% Mexican, 3.3% Other Hispanic, 2.4% Multi-racial, and 79.9% Non-Hispanic White. Overall LE8 scores tended to stay stable or decline between 2013-14 and 2017-18 for individuals with and without CVD (Figure 1). Significant decreases in mean LE8 scores occurred in those with HTN, with a 4.1% decline from 2013-18 (from 59.6 [95% CI: 58.4-60.8] to 57.1 [55.9-58.4]), stroke, with a 11.5% decline (from 60.6 [56.0-65.2] to 53.6 [50.7-56.5]), and HF, with a 15.2% decline (from 60.9 [57.2-64.6] to 51.6 [48.0-55.2]). Conclusions: Recent LE8 scores remained stable or declined for older US adults even before the pandemic. In particular, individuals with HTN, stroke, and HF had significant declines in LE8 scores. Since LE8 metrics include behavioral and physiologic metrics associated with CVD risk, these data indicate concerning trends and primary and secondary prevention opportunities in older US adults, who are at highest risk for incident and recurrent CVD events.