Abstract 16232: Life’s Essential 8 Cardiovascular Health Score and Cardiorespiratory Fitness in the Community

Abstract

Background: Cardiorespiratory fitness (CRF) is a key indicator of cardiovascular health (CVH) and is inversely associated with cardiovascular disease (CVD) and mortality, but its relations with lifestyle behaviors and factors linked with CVH are incompletely elucidated. Hypothesis: Greater CVH, as assessed by a score comprising lifestyle and standard risk factors, is associated with greater CRF. Aim: To evaluate the cross-sectional relations of AHA’s Life’s Essential 8 (LE8) metrics with CRF in the community. Methods: Maximal cardiopulmonary exercise tests (CPET) were performed in the Framingham Heart Study (FHS). An LE8 score was constructed for each participant by averaging scores across all LE8 components (ranging 0-100). We related CRF and other CPET measures with total LE8 score, individual LE8 components as three-level variables (optimal/suboptimal/poor), and changes in LE8 score over an ≈8 year interval. Results: In 1838 FHS participants (age 54±9 years, 54% women, BMI 28±5 kg/m 2 ), mean LE8 score was 76±12. In age- and sex-adjusted models, a higher LE8 score was associated with higher peak VO 2 , better ventilatory efficiency, lower resting heart rate, and favorable blood pressure response to exercise (p<0.0001 for all). A clinically meaningful 5-point higher LE8 score was associated with a 6.0% greater peak VO 2 (≈1.4 ml/kg/min at the sample mean). There was no evidence of effect modification by age, sex, or CVD status. The eight LE8 score components were statistically significantly associated with peak VO 2 in models adjusted for age and sex, but blood lipids, diet, and sleep health were no longer statistically significant after adjustment for all other LE8 components ( Figure ). Over an ≈8-year interval, a 5-unit increase in LE8 score was associated with a 3.7% higher peak VO 2 (p<0.0001). Conclusion: Higher LE8 score is associated with greater CRF in the community, highlighting the importance of CVH as assessed by LE8 metrics in maintaining and promoting CRF.