Abstract P508: Comparisons of Cardiovascular Health in US Adults by Chronic Disease Status: National Health and Nutrition Examination Survey (NHANES), 2013-2018

Abstract

Introduction: Cardiovascular health (CVH) assessment is typically applied to younger, healthy individuals in the setting of primordial prevention, but the concept may have important benefits for those with chronic diseases of aging (CDAs) at increased risk for incident cardiovascular disease (CVD). No studies have assessed CVH in adults with CDAs vs. healthy adults without CDAs using the new Life’s Essential 8 (LE8) metrics. Methods: We used NHANES data from 2013-2018 to identify presence of 15 CDAs by participant self-report of diagnosis. We included adults ages 20 to 79. CVH was defined by AHA’s LE8 metrics. Overall mean LE8 (range 0-100, higher = better CVH) and individual LE8 metric scores were calculated according to disease status for all participants and stratified by self-identified sex and race/ethnicity. Results: There were 12,296 adults, with mean age 46 years; 51% self-identified as female, 65% as White, 16% Hispanic, 11% Black, 5% Asian, 4% multiracial. Significantly, and often substantially, lower CVH scores were noted for adults with CDA (12 of 15 CDAs) vs. healthy adults, including all subtypes of CVD and lung diseases, liver disease, arthritis, cognitive decline, and depression. Greatest mean LE8 differences were detected for COPD, emphysema, and congestive heart failure. For example, mean overall LE8 score was 14.0 points lower in those with vs. without COPD (51.0 vs. 65.0, P<0.0001) with smoking and physical activity having the largest absolute differences in individual metric scores (36.4 and 23.6, respectively). There were no significant differences in LE8 scores for participants with vs. without cancer, HIV, or osteoporosis. Males and Black adults consistently had lower LE8 scores. Conclusions: CVH is significantly poorer in adults with many of the CDAs compared to healthy adults. These data establish the utility of the LE8 CVH score to identify groups for targeted optimization of CVH to enhance primary and secondary prevention efforts for CVD and potentially for other concomitant CDAs.