Gender differences in cardiovascular health over adolescence using the novel Life's Essential 8 score

Abstract

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): 1. Fondo de Investigación Sanitaria - Instituto de Salud Carlos III 2. SHE Foundation and “la Caixa” Foundation. Background/Introduction The evidence for gender differences in overall cardiovascular health (CVH) score and individual health metrics over adolescence is conflicting. Purpose To study gender differences in overall CVH status and its individual metrics in a large cohort of adolescents aged 12 to 16 years in Spain. Methods This study collected longitudinal data from 1324 adolescents at baseline (48.4% girls; 12.5 (0.4) years), 1211 (47.9% girls; 13.9 (0.4) years) at first follow-up and 1095 at second follow-up (48.2% girls; 15.8 (0.4) years) attending 24 secondary schools enrolled in the SI! Program for Secondary Schools trial in Spain. Eight individual metrics (nicotine exposure, diet, physical activity (PA), sleep health, body mass index (BMI), blood glucose, non-high-density lipoprotein cholesterol, and blood pressure (BP)) were measured and scored from 0 to 100 points according to the Life’s Essential 8 (LE8) criteria established by the American Heart Association. An overall CVH score was constructed summing the metrics described above, ranging from 0 to 100 points. Low, moderate, or high overall CVH score was defined as 0-49, 50-79, or 80-100 points, respectively. Differences in CVH over time were analyzed in individuals with CVH score available at three time-points (n=1077) using generalized linear mixed adjusted models. Results At approximately 12 years of age, most individuals had a moderate or high LE8 CVH score and CVH was slightly higher (healthier) in girls than boys (77.2 vs. 76.0 points) (Figure 1). LE8 CVH score increased significantly in boys and girls between 12 and 14 years of age (1.78 and 1.95 points, respectively), without gender differences (Figure 2). LE8 CVH score decreased significantly in boys and girls between 14 and 16 years of age; however, this decline was higher in boys than in girls (-3.17 versus -1.62 points, p value=0.007). Regarding individual metrics, mean scores were lowest for the diet, and sleep health and highest for BP. The highest declines over time were observed in PA, especially in boys, and nicotine exposure, especially in girls. Conclusions Most adolescents had a moderate or high overall CVH status, although boys showed slightly unhealthier scores and greater decline over time. Gender differences in individual CVH metrics were also found. This information is helpful for tailoring health promotion programs in adolescence.