Levels Of Cardiovascular Health Research Articles

Life’s essential 8, genetic susceptibility, and incident cardiac arrhythmias: a population-based prospective cohort study

Ideal cardiovascular health (CVH) has been associated with reduced cardiovascular disease risk and mortality, but its association with cardiac arrhythmias were still unsettled. In this prospective cohort study, we investigated the relationship between CVH and subsequent arrhythmias risk, including atrial fibrillation/flutter (AF), ventricular arrhythmias, and bradyarrhythmias. Data from 287,264 participants initially free of arrhythmias in the UK Biobank were included in the analysis. Cox regression models were used to examine the relationship between CVH levels calculated by the American Heart Association's Life's Essential 8 (LE8) metrics, with cardiac arrhythmias risk. During a median follow-up period of 12.8 years, 16,802 incident AF, 2186 incident ventricular arrhythmias, and 4128 incident bradyarrhythmias were identified. After adjustment for confounding factors, participants with high initial CVH levels had a significantly lower risk for AF (HR 0.63, 95% CI 0.59-0.68), ventricular arrhythmias (HR 0.48, 95% CI 0.40-0.59), and bradyarrhythmias (HR 0.64, 95% CI 0.55-0.74) compared to those with low CVH levels. Furthermore, each SD increase in LE8 scores was associated with a 15% lower risk of AF, 21% for ventricular arrhythmias, and 13% for bradyarrhythmias, respectively. Additionally, a significant interaction was observed between CVH levels and the genetic risk of AF (P for interaction, 0.021). The reverse correlation seemed to be more noticeable in individuals with a lower genetic susceptibility to AF. We concluded that higher levels of CVH, estimated by the LE8 metrics, were associated with significantly reduced risks of AF, ventricular arrhythmias, and bradyarrhythmias.

Association between life's essential 8 and testosterone deficiency in US men: findings from national health and nutrition examination survey (NHANES) 2011-2016.

Testosterone deficiency (TD) is closely associated with cardiovascular diseases (CVD). We intended to explore the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health, with the prevalence of TD among US male adults. The population-based cross-sectional study selected male adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. According to the American Heart Association definitions, the LE8 score was measured on a scale of 0-100, and divided into health behavior and health factor scores, simultaneously. Furthermore, these scores were categorized into low (0-49), moderate (50-79), and high (80-100) classifications. TD is defined as a total testosterone level below 300ng/dL. Correlations were investigated by weighted multivariable logistic regression, and the robustness of the results were verified by subgroup analysis. A total of 4971 male adults with an average age of 47.46 ± 0.41 years were eligible for the final analyses, of whom 1372 were determined to have TD. The weighted mean LE8 score of the study population was 68.11 ± 0.41. After fully adjusting potential confounders, higher LE8 scores were significantly associated with low risk of TD (odd ratio [OR] for each 10-point increase, 0.79; 95% CI, 0.71-0.88) in a linear dose-response relationship. Similar patterns were also identified in the association of health factor scores with TD (OR for each 10-point increase, 0.74; 95% CI, 0.66-0.83). These results persisted when LE8 and health factor scores was categorized into low, moderate, and high groups. The inversed association of LE8 classifications and TD remained statistically significant among older, obese, and men without CVD. LE8 and its health factor subscales scores were negatively associated with the presence of TD in linear fashions. Promoting adherence to optimal cardiovascular health levels may be advantageous to alleviate the burden of TD.

The protective role of cardiovascular health against kidney stones: A study based on LE8 score

ObjectivesThe American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH)-Life's Essential 8 (LE8) score. Our objective was to investigate the correlation between levels of CVH, as determined by the LE8 score, and the risk of kidney stones among a representative sample of adults in the United States. MethodsWe included data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007–2016 for further analysis. The LE8 score, a comprehensive measurement ranging from 0 to 100, was used to evaluate overall CVH and classified into three categories: low (0–49), moderate (50–79), and high (80–100) CVH. Logistic regression was employed to assess the association between the LE8 score and kidney stones. Furthermore, sensitivity analysis was conducted to validate the findings, and the presence of a non-linear relationship was examined using restricted cubic spline (RCS) regression methods. ResultsA total of 19,988 participants were included in this study (weighted mean age, 47.99 years; 95 % confidence interval [CI]: 47.46–48.53 years), with 10,319 being female (weighted percentage, 51.98 %; 95 % CI: 51.26–52.71 %) and 1923 identified as having kidney stones (weighted percentage, 9.95 %; 95 % CI: 9.41–10.53 %). In the fully-adjusted multivariable model, higher LE8 scores were associated with prevalence of self-reported kidney stones (odds ratio [OR] for a 10-unit increase in score, 0.86; 95 % CI: 0.82–0.91), presenting a linear dose-response relationship. Compared to the low CVH group, participants in the moderate and high CVH groups exhibited a lower prevalence of kidney stones (OR = 0.80; 95 % CI: 0.69–0.92; OR = 0.54; 95 % CI: 0.43–0.69, respectively). Similar trends were observed when assessing the association between health behavior scores and kidney stones. Moreover, the negative correlation between the LE8 score and the prevalence of kidney stones was markedly more pronounced in various stratified analyses. ConclusionOur study suggests that a higher level of CVH, as assessed by the LE8 metrics, is independently associated with a lower prevalence of self-reported kidney stones in a linear relationship. Further research, particularly through longitudinal or intervention studies, is required to establish whether actively promoting optimal CVH levels can effectively reduce the incidence of kidney stones.

Sex differences in Life's Essential Eight and its Association with mortality among US adults without known cardiovascular disease

BackgroundThe American Heart Association's (AHA) Life's Essential 8 (LE8) score is a helpful tool to quantify cardiovascular health (CVH) metrics. We sought to assess sex differences in relation to LE8 and its components along with association with mortality. MethodsThe National Health and Nutrition Examination Survey (NHANES) between 2009 and 2018 was utilized to evaluate the prevalence of health metrics included in LE8 among adult participants > age 18, stratified by sex. We categorized overall CVH, health factors, and health behaviors into 3 levels (low: <50, moderate: 50 -79, high: ≥80) following the AHA's algorithm. Health metrics were further subdivided into health behaviors (diet, physical activity, nicotine exposure, and sleep) and health factors (body mass index, non–high density lipoprotein cholesterol, blood glucose, and blood pressure). LE8 scores were also evaluated based on age, race/ethnicity, and socioeconomic status. Cox proportional hazard models were used to evaluate the association between the levels of CVH and risk of all-cause and cardiovascular mortality, with adjustment for age group and race. ResultsAmong 22,761 participants, 52 % were female. Overall CVH score was similar in both females and males (65.8 vs. 65.9). Females had higher health factors score (64.3 vs. 63.1, p < 0.001) and lower health behaviors score (67.2 vs 68.6, p < 0.001). Amongst individual metrics, blood pressure score was higher in females (73.2 vs. 67.7, p < 0.001) while males had higher physical activity score (70.6 vs. 54.9, p < 0.001). For individuals under 65 years of age, overall CVH and health factors scores were higher in females while in those age 65 or older, males had higher scores. The most prominent sex differences were noted in non-Hispanic Black females who had significantly lower CVH scores than Black males (62.6 vs. 74.7, respectively, p < 0.001. High LE8 scores vs. low LE8 scores demonstrated lower all-cause (HR 0.37 vs 0.35) and CV mortality (HR 0.35 vs. 0.36) in both males and females, respectively (p-interaction 0.21 and 0.28). High health behaviors scores also demonstrated a significant association with lower all-cause (0.34 vs. 0.24) and CV mortality (HR 0.47 vs. 0.26) in both males and females, respectively (p-interaction 0.20 and 0.11). ConclusionsWe demonstrate important sex differences in CVH metrics along with notable variations based on age and race/ethnicity. Furthermore, we highlight that CVH metrics including health factors and health behaviors are associated with mortality in both females and males. These findings underscore the importance of designing and implementing effective strategies for both sexes, aimed at targeting these specific factors.

Reproductive factors and cardiovascular health in post-menopausal women: a special focus on natural menopause

ABSTRACT Female-specific reproductive factors might contribute to increased risk of cardiovascular disease, and the American Heart Association (AHA) recently proposed Life’s Essential 8 (LE8) score to quantify cardiovascular health (CVH). The study aimed to examine the relationships between reproductive factors and the LE8 score among post-menopause women in the United States. We enrolled 3223 post-menopause women from National Health and Nutrition Examination Survey (NHANES). CVH groups based on LE8 score were low (0–49), moderate (50–79), and high good CVH levels (80–100). Multivariate ordinal logistic regressions were applied to estimate the associations between reproductive factors and the LE8 score. In multivariate model, early menarche (OR: 0.69, 95 percent CI: 0.51–0.93) and early menopause (OR: 0.57, 95 percent CI: 0.43–0.77) were associated with LE8 score compared with normal menarche and menopause; Meanwhile, ages at menarche and menopause were positively correlated with LE8 score. The number of pregnancies and full-term pregnancies were negatively associated with LE8 (OR for per pregnancy increase and 95 percent CI, 0.93 (0.88, 0.98), 0.93 (0.87, 0.99), separately). Overall, natural menopausal women with early age at menarche and menopause, and a higher number of pregnancies may have a high risk of lower CVH, and need to focus on their CVH.

Cardiovascular Health and Colorectal Cancer Screening in Black Men: A Cross-Sectional Analysis.

African American/Black (henceforth Black) men face disproportionate risks of morbidity and mortality from both cardiovascular disease (CVD) and colorectal cancer (CRC). The American Heart Association's Life's Simple 7 (LS7) tool was designed to examine predictors of CVD with included behaviors also linked to CRC risk (i.e., smoking status, weight, diet, and physical activity). However, no studies have combined LS7 assessment alongside CRC screening history, which serves as a proxy for assessing CRC risk, in Black men. In this study, Black men aged 45-75 participating in annual community wellness events were screened for 6 of 7 LS7 measures (excluding diet, LS6) and self-reported CRC screening. Analyses conducted using R 4.0.5. revealed that Black men (N = 680), with an average age of 57.3 years (SD = 7.5), reported poor (39.7%), intermediate (34.6%), or ideal (25.7%) LS6 scores with higher scores corresponding to lower risk for CVD. However, for every 1-point increase in LS6 scores (0-6), there was a 26% lower odds of reported CRC screening (p = .001). In the fully adjusted model, men with 4+ ideal LS6 behaviors had a 60% lower odds of self-reported CRC screening compared to those with two ideal LS6 behaviors (p < .001). These findings underscore the need for culturally relevant interventions for Black men across all levels of cardiovascular health (CVH) to increase CRC screening uptake.

A CASE STUDY OF THE PHYSIOLOGICAL AND PSYCHOLOGICAL RESPONSES TO COACHING PROFESSIONAL AUSTRALIAN FOOTBALL

INTRODUCTION &amp; AIMS Coaching professional sport is stressful, yet there is little information detailing the physiological and psychological responses of coaches during match-play. The burden of measurement instruments during competition may preclude their use with coaches during this high-pressure part of the coaching cycle. This exploratory case study examined physiological and psychological alterations when coaching professional Australian football to determine the potential health implications and enhance health literacy in coaches. METHODS One head coach of a professional football team was monitored for heart rate (HR), stress-related hormones (C-Reactive Protein, Cortisol, Troponin, Brain Natriuretic Peptide) and psychological stress prior to, during and following seven matches and descriptive data was examined. RESULTS The HR response indicated sustained elevation during match-play, with the intermittent nature of the game causing an undulating profile. Periods of locomotion during breaks in play led to elevations in HR, with maximum HR recorded as 8% above age-predicted maximum. Further, differences in HR were evident in the final five minutes between small (145 ± 7.0 bpm) and large (113 ± 5.1 bpm) score margins. There were no irregularities for stress hormones, while the psychological questionnaire revealed differences in perceptions of accomplishment, success, recovery and stress related to match outcome. CONCLUSIONS This exploratory case study indicated that substantial elevations in HR are evident while coaching professional football, yielding implications for health management. Coaches require appropriate levels of cardiovascular health to cope with the demands of coaching and targeted health intervention programs may be warranted. Further, differences in psychological outcomes from winning or losing may reflect the need to develop recovery and coping strategies that are contextualised to match results. Since match-play observation elicits alterations to physical and psychological markers, confirmatory research with larger cohorts is warranted to examine and enhance well-being and health management strategies in these elite performers.

Sleep Patterns and Traditional Cardiovascular Health Metrics: Joint Impact on Major Adverse Cardiovascular Events in a Prospective Cohort Study.

This study examines the association between traditional cardiovascular health (CVH) metrics and major adverse cardiovascular events (MACE) incidence in individuals with diverse sleep patterns. We analyzed data from 208 621 participants initially free of cardiovascular disease (CVD) in the UK Biobank study. Sleep patterns were assessed using scores for chronotype, duration, insomnia, snoring, and daytime dozing. Traditional CVH scores were derived from the Life's Simple 7 metrics. Cox proportional hazards multivariate regression assessed associations between distinct combinations of CVH and sleep scores and MACE, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Over a mean follow-up of 12.73 years, 9253 participants experienced incident MACE. Individuals with both a healthy sleep pattern and ideal CVH levels had the lowest MACE risk compared with those with a poor sleep pattern and poor CVH levels (hazard ratio, 0.306 [95% CI, 0.257-0.365]; P<0.001). Elevated CVH scores were associated with a reduced risk of MACE across different sleep patterns. Similar trends were observed for individual MACE components, heart failure, and all-cause mortality. These findings remained robust in sensitivity analyses and across various subgroups. In individuals without known CVD, maintaining a favorable sleep pattern and achieving optimal CVH levels, as measured by traditional metrics, were associated with the lowest MACE risk. Enhanced CVH significantly reduced CVD risk, even in individuals with a poor sleep pattern. These results emphasize the importance of considering multiple dimensions of sleep health alongside CVH to mitigate CVD risk. URL: https://www.ukbiobank.ac.uk; Unique identifier: 91090.

Association between kidney stones and life's essential 8: a population-based study

BackgroundKidney stones exhibit a robust correlation with cardiovascular disease (CVD). The objective of this research is to investigate the correlation between kidney stones and Life's Essential 8 (LE8), a newly updated assessment of cardiovascular health (CVH), among adults in the United States.MethodsIn this study, which analyzed data from the 2007–2018 National Health and Nutrition Examination Survey, we employed LE8 scores (ranging from 0 to 100) as the independent variable, classifying them into low, moderate, and high CVH categories. The research examined the relationship between LE8 scores and kidney stones by using multivariate logistic regression and restricted cubic spline models, with kidney stones as the dependent variable.ResultsOut of the 14,117 participants in this research, the weighted mean LE8 score was 69.70 ± 0.27. After accounting for confounding factors, there was an inverse association between higher LE8 scores and the likelihood of developing kidney stones (OR of 0.81 per 10-point increase, with a 95% confidence interval of 0.77–0.85), demonstrating a non-linear dose–response pattern. Similar patterns were observed for health behaviors, health factor scores, and kidney stones. Stratified analyses demonstrated a stable negative correlation between LE8 scores and kidney stones across different subgroups.ConclusionLE8 and its subscale scores exhibited a robust and inverse correlation with the occurrence of kidney stones. Encouraging adherence to optimal CVH levels has the potential to serve as an effective strategy in preventing and minimizing the occurrence of kidney stones.

Association of Cardiovascular Health with the Incidence of Venous Thromboembolism: A Prospective Study of 275,149 Participants from the UK Biobank.

The Life's Essential 8 (LE8) score, recently proposed by the American Heart Association, represents a new paradigm for evaluating cardiovascular health (CVH). We aimed to explore the association between CVH, estimated using LE8, and venous thromboembolism (VTE) incidence. A total of 275,149 participants were recruited from the UK Biobank and divided into high (LE8 score ≥ 80), moderate (LE8 score < 80 but ≥50), and low (LE8 score < 50) CVH groups. Restricted cubic spline analysis, the Kaplan-Meier method, and the Cox proportional hazards model were used to explore the association between CVH and VTE. The genetic predisposition to VTE was assessed with a polygenic risk score. Sensitivity analyses were performed to validate the results. During a median follow-up of 12.56 years, VTE developed in 506 (4.09%), 6069 (2.78%), and 720 (1.66%) participants with low, moderate, and high CVH levels, respectively. Compared with the low CVH group, participants in the moderate and high CVH groups had a 23% (HR, 0.77; 95% CI, 0.71-0.85) and 41% (0.59, 0.52-0.66) lower risk of VTE, respectively, after adjusting for demographic characteristics, medical history, socioeconomic status, and genetic predisposition. This association remained robust in multiple sensitivity analyses. Higher CVH levels led to a more pronounced reduction in the risk of VTE in females and could appreciably offset the genetic risk of VTE. Higher CVH levels were significantly associated with a lower incidence of VTE, encouraging efforts to increase LE8 scores in individuals.

Association Between `Life's Essential 8` and Periodontitis: A Cross-Sectional Study From the NHANES Database

BackgroundPeriodontitis as a chronic inflammatory disease, and its persistent inflammatory state can lead to the cardiovascular system damage. Studies have shown that life's essential 8 (LE8), as an indicator of cardiovascular health, was associated with the risk of several inflammatory diseases. This study aimed to assess the association between LE8 and its subscales and the risk of periodontitis. MethodsData of participants who accepted the periodontitis examinations were extracted from the National Health and Nutrition Examination Surveys (NHANES) database (2009-2014). LE8 contains four health behaviors (diet, physical activity, nicotine exposure, sleep health) and four health factors (BMI, blood lipids, blood glucose and blood pressure) and was categorized into low (0-49), moderate (50-79), and high (80-100) level. Covariates included demographic information, laboratory values, diseases history and medications history. The weighted univariate and multivariate logistic regression models were performed to assess the association between LE8 and periodontitis, with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses based on different age, gender and cardiovascular disease (CVD) history were further assessed the association. ResultsTotal 5,106 adults were included, of whom 2,606 (51.04%) had periodontitis. After adjustment for age, gender, race, PIR, education level, marital status, drinking, CVD, nonsteroidal anti-inflammatory agents, waist circumference (WC), vitamin D (VD) and dental floss/device, high LE8 score (OR=0.48, 95%CI: 0.32-0.73), higher health behaviors score (OR=0.56, 95%CI: 0.42-0.73) and higher health factors score (OR=0.71, 95%CI: 0.51-0.99) were associated with the lower occurrence of periodontitis, especially in adults with male, aged <60 years and without CVD history. Moreover, the occurrence of periodontitis was decreased when score of total LE8, health factors and health behaviors increased every 10 scores. ConclusionLE8 score and its subscales scores were associated with the lower odds of periodontitis. Promoting adherence to high cardiovascular health levels may be beneficial to reduce the burden of periodontitis.

Abstract P529: Ideal Cardiovascular Health May Mitigate Age-Related Increases in Subclinical Myocardial Damage in US Adults

Background: High-sensitivity cardiac troponins (hs-cTn) levels reflect myocardial damage and increase with age. Even minor elevations in hs-cTn are linked to increased cardiovascular risk. Little data exists on how level of cardiovascular health impacts age-related rises in hs-cTn among individuals in the population. Methods: We conducted a cross-sectional analysis of 6,955 adults aged 20 years or older free of self-reported coronary artery disease and heart failure who participated in the 1999-2004 National Health and Nutrition Examination Survey. Hs-cTnT and hs-cTnI were measured from stored samples. Total cardiovascular health was modeled using the AHA’s Life’s Essential 8 metrics (all variables excluding sleep) and categorized as low, moderate, or high. For the distinct participants within each level of cardiovascular health, we compared average levels (geometric means) of hs-cTn across each decade of age. Using multivariable linear regression, we estimated the percent rise in hs-cTn per decade within each cardiovascular health stratum. Results: The mean age was 45 years, with 54% being female and 72% being White adults. There was a stepwise rise in average levels of hs-cTn per decade, however the difference in average hs-cTn in older age vs young adulthood was least for those with high cardiovascular health, and greater for those with lesser cardiovascular health (Figure). In linear regression, those with high cardiovascular health had lesser percent rise in hs-cTnT per decade than those with moderate and low cardiovascular health (13% vs 19% vs 23%, p interaction &lt;0.001). Similar differences per decade between those with high versus moderate and low cardiovascular health were seen for hs-cTnI (17% vs 19% vs 23%, p interaction = 0.04). Conclusion: Level of cardiovascular health may influence the degree of myocardial damage associated with aging. Mitigation of age-related myocardial damage may be one mechanism underlying the cardiovascular benefits of maintaining ideal cardiovascular health.

Factors Associated With the Cardiovascular Health of Black and Latino Adults With Type 2 Diabetes.

The purpose of this study was to assess the levels of cardiovascular health (CVH) of Black and Latino adults with type 2 diabetes (T2D) and examine the association of individual and microsystem level factors with their CVH score. This was a cross-sectional design in 60 Black and Latino Adults aged 18-40 with T2D. Data were collected on sociodemographic, individual (sociodemographic, diabetes self-management, sleep disturbance, depressive symptoms, quality of life, and the inflammatory biomarkers IL-6 and hs-CRP) and microsystem factors (family functioning), and American Heart Association's Life's Simple 7 metrics of CVH. Factors significantly associated with the CVH score in the bivariate analyses were entered into a linear regression model. The sample had a mean age 34 ± 5years and was primarily female (75%) with a mean CVH score was 8.6 ± 2.2 (possible range of 0-14). The sample achieved these CVH factors at ideal levels: body mass index <25kg/m2 (8%); blood pressure <120/80 (42%); hemoglobin A1c < 7% (57%); total cholesterol <200mg/dL (83%); healthy diet (18%); never or former smoker > one year (95%); and physical activity (150 moderate-to-vigorous minutes/week; 45%). In the multivariable model, two factors were significantly associated with cardiovascular health: hs-CRP (B = -0.11621, p < .0001) and the general health scale (B = 0.45127, p = .0013). This sample had an intermediate level of CVH, with inflammation and general health associated with overall CVH score.

Association of cardiovascular health metrics with all-cause and cardiovascular disease mortality in chronic kidney disease: A cohort study

Background and aimsSince the global burden of chronic kidney disease (CKD) is rising rapidly, the study aimed to assess the association of cardiovascular health (CVH) metrics with all-cause and cardiovascular disease (CVD) mortality among individuals with CKD. Methods and resultsThe cohort study included 5834 participants with CKD from the National Health and Nutrition Examination Survey 1999–2018. A composite CVH score was calculated based on smoking status, physical activity, body mass index, blood pressure, total cholesterol, diet quality, and glucose control. Primary outcomes were all-cause and CVD mortality as of December 31, 2019. Multivariable-adjusted Cox proportional hazards models were used to estimate the association between CVH metrics and deaths in CKD patients. During a median follow-up of 7.2 years, 2178 all-cause deaths and 779 CVD deaths were documented. Compared to participants with ideal CVH, individuals with intermediate CVH exhibited a 46.0% increase in all-cause mortality (hazard ratio, 1.46; 95% confidence interval: 1.17, 1.83), while those with poor CVH demonstrated a 101.0% increase (2.01; 1.54, 2.62). For CVD mortality, individuals with intermediate CVH experienced a 56.0% increase (1.56; 1.02, 2.39), and those with poor CVH demonstrated a 143.0% increase (2.43; 1.51, 3.91). Linear trends were noted for the associations of CVH with both all-cause mortality (P for trend <0.001) and CVD mortality (P for trend = 0.02). ConclusionsLower CVH levels were associated with higher all-cause and CVD mortality in individuals with CKD, which highlights the importance of maintaining good CVH in CKD patients.

Relationship Between Ultra-Processed and Minimally Processed Food Intake and Cardiovascular Health Among US Women of Reproductive Age.

Objectives: Ultra-processed food (UPF) intake is associated with worse cardiovascular health (CVH), but associations between unprocessed/minimally processed foods (MPFs) and CVH are limited, especially among women of reproductive age (WRA). Materials and Methods: For 5,773 WRA (20-44 years) in National Health and Nutrition Examination Survey (NHANES) 2007-2018, we identified UPFs and MPFs using the Nova classification and based on 24-hour dietary recalls. We calculated usual percentages of calories from UPFs and MPFs using the National Cancer Institute's usual intake method. Seven CVH metrics were scored, and CVH levels were grouped by tertile. We used multivariable linear and multinomial logistic regression to assess associations between UPFs and MPFs and CVH. Results: The average usual percentage of calories from UPFs and MPFs was 57.2% and 29.3%, respectively. There was a graded, positive association between higher UPF intake and higher odds of poor CVH: adjusted odds ratios (aORs) for the lowest versus highest CVH were 1.74 (95% confidence interval: 1.51-2.01), 2.67 (2.07-3.44) and 4.66 (3.13-6.97), respectively, comparing quartile 2 (Q2)-Q4 to the lowest quartile (Q1) of UPF intake. Higher MPF intake was associated with lower odds of poor CVH: aORs for the lowest CVH were 0.61 (0.54-0.69), 0.39 (0.31-0.50), and 0.21 (0.14-0.31). Patterns of association remained consistent across subgroups and in sensitivity analyses. Conclusions: Higher UPF intake was associated with worse CVH, while higher MPF intake was associated with better CVH among WRA in the United States. Our analyses highlight an opportunity for WRA to improve nutrition and their CVH.

Associations between cardiovascular health and female infertility: A national population-based study.

This study investigates the relationship between cardiovascular health (CVH), as quantified by the American Heart Association's Life's Essential 8 (LE8) metric, and female infertility, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2013-2018. We encompassed females aged 20-49 years and above from the NHANES in this cross-sectional analysis. We assessed CVH using the LE8 score, encompassing eight domains: dietary pattern, physical activity, nicotine exposure, sleep duration, body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure levels. Logistic regression models were applied to explore the association between CVH scores and reported infertility, adjusting for potential confounders including age, race/ethnicity, and socioeconomic status. Findings revealed a notable inverse association between CVH scores (per 10 scores) and female infertility [OR = 0.93, 95%CI: 0.90-0.96], Participants with higher CVH levels were 41% less likely to had female infertility compared to those with lower levels [OR = 0.59, 95%CI: 0.41-0.84]. Higher overall CVH scores, particularly in physical activity, BMI, and blood glucose, were associated with lower odds of infertility. This trend remained consistent across various demographic subgroups. Our findings underscore the significance of maintaining optimal cardiovascular health, as evidenced by higher LE8 scores, in mitigating the risk of female infertility. These insights advocate for the integration of CVH improvement strategies within the broader framework of reproductive health care, emphasizing the dual benefits of cardiovascular and reproductive health optimization.

Associations Between Life's Essential 8 and Chronic Kidney Disease.

Chronic kidney disease (CKD) is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health, with the prevalence of CKD among US adults. This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey from 2007 to 2018 and included adults aged ≥20 years. Multivariable logistic and restricted cubic spline models were used to assess the associations between LE8 and CKD. Among 24 960 participants, 4437 were determined to have CKD (weighted percentage, 14.11%). After the adjustment of potential confounders, higher LE8 scores were associated with reduced odds of CKD (odds ratio for each 10-point increase, 0.79 [95% CI, 0.76-0.83]), and a nonlinear dose-response relationship was observed. Similar patterns were also identified in the associations of health behavior and health factor scores with CKD. Meanwhile, higher scores for blood glucose (odds ratio, for each 10-point increase, 0.88 [95% CI, 0.87-0.90]) and blood pressure (odds ratio, for each 10-point increase, 0.92 [95% CI, 0.91-0.94]) in the LE8 component are significantly associated with a lower prevalence of CKD. The inversed association of LE8 score and CKD was significantly stronger among middle-aged, male, and coupled participants. LE8 was negatively associated with the prevalence of CKD in a nonlinear fashion. Promoting adherence to optimal cardiovascular health levels may be beneficial to reduce the burden of CKD.

Comparison of Cardiovascular Health Profiles Across Population Surveys From 5 High- to Low-Income Countries

BackgroundTo facilitate the shift from risk-factor management to primordial prevention of cardiovascular disease, the American Heart Association developed guidelines to score and track cardiovascular health (CVH). How the prevalence and trajectories of a high level of CVH across the life course compare among high- and lower-income countries is unknown. MethodsNationally representative survey data with CVH variables (physical activity, cigarette smoking, body mass index, blood pressure, blood glucose, and total cholesterol levels) were identified in Ethiopia, Bangladesh, Brazil, England, and the US for adults (aged 18–69 years and not pregnant). Data were harmonized, and CVH metrics were scored using the American Heart Association guidelines, as high (2), moderate (1), or low (0), with the prevalence of high scores (better CVH) across the life course compared across countries. ResultsAmong 28,092 adults (Ethiopia n = 7686, 55.2% male; Bangladesh n = 6731, 48.4% male; Brazil n = 7241, 47.9% male; England n = 2691, 49.5% male, and the US n = 3743, 50.3% male), the prevalence of high CVH scores decreased as country income level increased. Declining CVH with age was universal across countries, but differences were already observable in those aged 18 years. Excess body weight appeared to be the main driver of poor CVH in higher-income countries, and the prevalence of current smoking was highest in Bangladesh. ConclusionsOur findings suggest that CVH decline with age may be universal. Interventions to promote and preserve CVH throughout the life course are needed in all populations, tailored to country-specific time courses of the decline. In countries where the level of CVH remains relatively high, protection of whole societies from risk-factor epidemics may still be feasible.

Sex and Age Differences in the Association Between Social Determinants of Health and Cardiovascular Health According to Household Income Among Mongolian Adults: Cross-Sectional Study.

Although social determinants of health (SDH) are an underlying cause of poor cardiovascular health (CVH), there is insufficient evidence for the association between SDH and CVH, which varies by sex and age among Mongolian adults. We aimed to explore whether education, household income, and health insurance were associated with CVH according to sex and age among Mongolian adults. The final sample included data on 5691 participants (male: n=2521. 44.3% and female: n=3170, 55.7%) aged 18-69 years from the 2019 World Health Organization STEPwise approach to noncommunicable disease risk-factor surveillance. CVH was measured using a modified version of Life's Simple 7 with 4 health behaviors (cigarette smoking, BMI, physical activity, and a healthy diet) and 3 biological factors (blood pressure, fasting glucose, and total cholesterol blood levels) and classified into poor, intermediate, and ideal levels as recommended by the American Heart Association. Multinomial logistic regression analyses examined the associations between SDH and CVH by monthly equivalized household income after adjusting for age, sex, work status, area, history of myocardial infarction or stroke, use of aspirin, and use of statin. Subgroup analyses were conducted to examine the associations between SDH and CVH based on sex and age, considering monthly equivalized household income as a key variable. Using the ideal level of CVH as a reference, among those with the lowest household income, having less than 12 years of education, and not having health insurance were associated with poor CVH (education level: odds ratio [OR] 2.42, 95% CI 1.30-4.51; P=.006; health insurance: OR 2.17, 95% CI 1.13-4.18; P=.02). These associations were more profound among female individuals (education level: OR 2.99, 95% CI 1.35-6.63; P=.007; health insurance: OR 2.54, 95% CI 1.09-5.90; P=.03) and those aged 18-44 years (education level: OR 3.22, 95% CI 1.54-6.72; P=.002; health insurance: OR 2.03, 95% CI 0.98-4.18; P=.06). Participants in the lowest household income group with lower educational levels and without health insurance were more likely to have poor CVH, and these results were more pronounced in female individuals and young adults. These findings suggest the need to develop strategies for CVH equity in Mongolian female individuals and young adults that consider income levels, education levels, and health insurance.

Abstract 12187: Association Between Ultra-Processed Food Intake and Cardiovascular Health Among US Women of Reproductive Age: NHANES 2007-2018

Introduction: Studies have showed that higher intake of ultra-processed foods (UPF) is associated with increased risk of lower cardiovascular health (CVH) among adolescents and adults. As UPF intake is a modifiable risk factor of cardiovascular disease, examining the association of UPF and CVH among women of reproductive age (WRA) may help improve CVH among this population. Hypothesis: A higher percentage of calories (%kcal) from UPF is associated with lower CVH among WRA aged 22-44 years. Methods: We analyzed data on 5,780 WRA from NHANES 2007-2018. UPF was assigned from the Nova classification, which categorizes foods according to the extent and purpose of food processing. CVH was defined by using the Life’s Essential 8 (LE8) on a scale of 0 to 100. Scores of the seven LE8 metrics (excluding diet) were averaged, and the levels of CVH (low, moderate, and high) were defined using tertiles. We estimated the usual %kcal from UPF intake by using up to two 24-hour dietary recalls and the National Cancer Institute’s usual intake method to account for measurement error. We used multivariable linear and multinomial logistic regression to assess the association between UPF and CVH, adjusting for covariates. Results: The mean usual %kcal from UPF was 57.2%, and midpoint of quartiles of intake were 43.8%, 53.5%, 60.9%, and 70.6% for Q1, Q2, Q3, and Q4, respectively. Every 10% increase in calories from UPF was associated with 3.6 points lower CVH score ( P &lt; .001). The adjusted odds ratios and 95% confidence intervals for low CVH were 1.76 (1.52-2.03), 2.70 (2.10-3.47), and 4.72 (3.19-7.04), respectively, comparing Q2, Q3, and Q4 to Q1 of UPF intake. The corresponding adjusted odds ratio and 95% confidence intervals for moderate CVH were 1.17 (1.02-1.34), 1.32 (1.04-1.68), and 1.55 (1.06-2.26). The pattern of association was largely consistent across subgroups, except for non-Hispanic Black women, and was consistent across sensitivity analyses. Conclusions: Among US WRA, UPF represented more than half of total calorie intake and showed a graded inverse association with CVH. Our analyses highlight the importance of limiting the consumption of UPF among WRA to maintain CVH.