Abstract Aim To evaluate the association of cardiovascular health (CVH) with incident heart failure (HF). Methods The China PEACE million persons project is a nationwide, government-funded and population-based cardiovascular disease (CVD) screening study. This was a sub-cohort study of the project that included community-dwelling adults free of CVD. Components of CVH, including diet, physical activity, smoking status, sleep status, body mass index (BMI), non-HDL, blood glucose and blood pressure, were collected using self-report questionnaires. Each component and CVH were categorized as poor, intermediate and ideal status based on the AHA Life’s Essential 8 criteria. HF cases were identified by linking hospital records. Results Among the cohort (n=38571, median age 54 years and women 60.5%), proportion of individuals with poor, intermediate and ideal CVH was 30.7%, 56.9% and 12.4% respectively. After a median follow-up of 3.6 years, the incidence of HF in individuals with poor, intermediate and ideal CVH was 2.5%, 1.1% and 0.5% (P<0.001). Compared to poor CVH, intermediate (adjusted HR: 0.52 [95% CI: 0.43-0.61]) and ideal CVH (adjusted HR: 0.38 [95% CI: 0.26-0.57]) were associated with a lower risk of incident HF. A gradient of association between CVH and risk of incident HF was observed (P-trend < 0.001). Ideal physical activity, ideal smoking status, and intermediate and ideal status of BMI, blood glucose and blood pressure were independently associated with a lower risk of incident HF. Conclusion Poor CVH was independently associated with an increased risk of incident HF and promotion of CVH may have important implications for HF prevention.Graphical abstract