Abstract P533: Association Between Cardiovascular Health and Carotid Arterial Ultrasound Markers Among Young Adults Using AHA’s “Life’s Essential 8” Metrics

Abstract

Background: In 2022, the American Heart Association (AHA) published a new set of cardiovascular health (CVH) guidelines, named Life's Essential 8 (LE8), as an update to the AHA’s previous definition of ideal CVH, Life’s Simple 7 (LS7). This study used both LE8 and LS7 scores to investigate associations between CVH and carotid markers among young adults. Methods: This cross-sectional study included 240 young adults (age 24.2±1.6) who underwent a carotid ultrasound between 2018 to 2022. LE8 score was calculated from 8 metrics including four health factors (body mass index (BMI), non-high density lipid (non-HDL) levels, fasting glucose, and blood pressure), and four health behaviors (physical activity, dietary pattern, tobacco use, and sleep). LS7 was calculated from 7 metrics (all LE8 metrics, except for sleep) with a simpler algorithm. Higher LE8 and LS7 scores both indicate better adherence to CVH guidelines. Carotid artery intima-media thickness (CIMT), arterial stiffness (CAS), and lipid deposition (determined by gray scale median, GSM) were evaluated by carotid ultrasound. Linear regression analyses were conducted to assess the association of LE8 and LS7 with carotid markers, adjusting for age, sex, race/ethnicity, and parents’ highest degree. Results: After adjusting for covariates, a one standard deviation (SD) increase in LE8 score was associated with 11.11μm lower CIMT (95% confidence interval[ CI] , -19.91 -2.30; p , 0.014), 1.20 (10 -6 xm 2 /N) greater distensibility (95% CI , 0.12 2.29; p 0.030), and 2.62 greater GSM (95% CI , 0.51 4.73; p 0.015). Analyses using LS7 score demonstrated consistent findings. Individual health factor metrics demonstrated stronger association with carotid markers, as compared to individual behavior metrics. One-SD increase in LE8 BMI score was associated with 19.37μm lower CIMT (95% CI , -27.66 -11.07; p <0.001), 2.33 greater distensibility (95% CI , 1.31 3.35; p 0.001), and 6.10 greater GSM (95% CI, 4.18 8.03; p <0.001). Similar trends were observed for LE8 scores for lipids and blood pressure with carotid measures. Conclusion: Greater adherence to CVH guidelines is associated with better carotid arterial health in young adults, evidenced by lower CIMT, less arterial stiffness, and less lipid deposition. LE8 and LS7 demonstrated comparable associations with carotid markers, with LE8 displaying a slightly stronger association with CIMT.