Abstract 36: Life’s Essential 8 and Life Expectancy Among Adults in the United States

Abstract

Background: Cardiovascular disease (CVD) may be the main reason for stagnant growth in life expectancy in the US since 2010. The American Heart Association (AHA) recently released updated algorithm for evaluating cardiovascular health (CVH)--life’s essential 8 (LE8) score. Hypothesis: We aimed to quantify the associations of CVH levels, estimated by the LE8 score, with life expectancy in a nationally representative sample of US adults. Methods: We included 23003 adults who participated in the National Health and Nutrition Examination Survey (NHANES) 2005-2018 and whose mortality was identified through linkage to the National Death Index through December 31, 2019. Life table method was used to estimate life expectancy by levels of the CVH. The cause-specific decomposition of the life expectancy differences was evaluated by the Arriaga’s method. Results: During a median of 7.8 years of follow-up, 1359 total deaths occurred (772 in men and 587 in women). The estimated life expectancy at age 50 was 25.5 years (95% CI, 23.8-27.2), 31.2 years (95% CI, 30.4-31.9) and 33.1 years (95% CI, 29.8-36.2) in men with poor, intermediate and ideal CVH, respectively. The corresponding estimated life expectancy at age 50 in women was 29.5 years (95% CI, 27.8-31.1), 34.2 years (95% CI, 33.5-34.9) and 38.4 years (95% CI, 35.4-41.0), respectively. Equivalently, men and women with ideal CVH had an average 7.5 (95% CI, 3.5-11.5) and 8.9 (95% CI, 5.2-12.5) more years of life expectancy at age 50, respectively, compared with their counterparts with poor CVH. In men, on average, 41.8 % of the gained life expectancy at age 50 from adhering to ideal CVH was attributable to reduced CVD death. The corresponding percentage was 44.1 % in women. Similarly significant associations of CVH with life expectancy were observed in Non-Hispanic Whites and Non-Hispanic Blacks but not in Mexican Americans. Conclusions: Adhering to an ideal CVH, defined as the LE8 score, is related to a considerably increased life expectancy in the US adults.