Abstract P132: Application of Life’s Essential 8 to Assess the Status of Cardiovascular Health Among 4-to-6-year-old Children in the Healthy Start Study

Abstract

Introduction: The American Heart Association recently put forth the Life’s Essential 8 (LE8) scoring system to assess cardiovascular health (CVH) status based on four health factors: body mass index [BMI], fasting glucose, non-high-density-lipoprotein cholesterol, and blood pressure; and four behavioral factors: first- and second-hand nicotine exposure, diet quality, physical activity, and sleep duration. Few studies have applied LE8 to assess CVH in children, and little remains known about concordance in CVH status based on LE8 vs. Life’s Simple 7 (LS7), the prior scoring system that employed different definitions and thresholds for defining CVH. Objectives: (1) Apply LE8 to assess prevalence (%) of low, moderate, high, and optimal CVH in diverse 4-to-6-year old children; (2) Compare concordance in CVH status categories based on LE8 vs. LS7. Hypothesis: Use of LE8 will yield at least 20% prevalence of high and optimal CVH; this prevalence will be higher than estimates based on LS7. Methods: Using data from 305 children in the Healthy Start cohort, we applied the LE8 scoring system to derive a composite CVH score for each child and estimated % low (LE8 CVH score <50 of 100 possible points), moderate (score 50-<80), high (score 80-<100), and optimal CVH (score=100). Next, we applied the LS7 scoring system to estimate % of participants in the same four categories (low CVH: LS7 CVH score <7 of 14 possible points; moderate CVH: score 7-<10.5; high CVH: score 10.5-<14; optimal CVH: score=14). Finally, we assessed concordance in prevalence across CVH status categories for LE8 vs. LS7 using the Wald chi-squared test, and calculated the correlation between continuous CVH scores based on LE8 and LS7. Results: The average age of participants was 4.7±0.6 y. Forty-five percent were female (n=136); 62% identified as white, 23% as Hispanic, and 12% as Black. No children had low or optimal CVH with either scoring system. However, prevalence of high CVH was higher based on LE8 than LS7 (40.6% vs. 33.4%; P <0.0001). Twenty-one percent of participants had high CVH according to both scoring systems. We observed a moderate positive correlation (Pearson R 2 =0.55) between continuous CVH scores for LE8 and LS7. Conclusions: While no participants had low or optimal CVH in Healthy Start during early childhood, LE8 yielded a higher prevalence of high CVH than LS7. Future studies are warranted to assess determinants and consequences of CVH status during this life stage.