Cardiovascular Health Score Research Articles

History of Infertility and Midlife Cardiovascular Health in Female Individuals

Fertility status is a marker for future health, and infertility has been associated with risk for later cancer and diabetes, but associations with midlife cardiovascular health (CVH) in female individuals remain understudied. To evaluate the association of infertility history with CVH at midlife (approximately age 50 years) among parous individuals. Project Viva is a prospective cohort study of pregnant participants enrolled between 1999 and 2002 who delivered a singleton live birth in the greater Boston, Massachusetts, area. Infertility history was collected at a midlife visit between 2017 and 2021, approximately 18 years after enrollment. Data analysis was performed from January to June 2023. The primary exposure was any lifetime history of infertility identified by self-report, medical record, diagnosis, or claims for infertility treatment. The American Heart Association's Life's Essential 8 (LE8) is a construct for ranking CVH that includes scores from 0 to 100 (higher scores denote better health status) in 4 behavioral (diet, physical activity, sleep, and smoking status) and 4 biomedical (body mass index, blood pressure, blood lipids, and glycemia) domains to form an overall assessment of CVH. Associations of a history of infertility (yes or no) with mean LE8 total, behavioral, biomedical, and blood biomarker (lipids and glycemia) scores were examined, adjusting for age at outcome (midlife visit), race and ethnicity, education, household income, age at menarche, and perceived body size at age 10 years. Of 468 included participants (mean [SD] age at the midlife visit, 50.6 [5.3] years) with exposure and outcome data, 160 (34.2%) experienced any infertility. Mean (SD) LE8 scores were 76.3 (12.2) overall, 76.5 (13.4) for the behavioral domain, 76.0 (17.5) for the biomedical domain, and 78.9 (19.2) for the blood biomarkers subdomain. In adjusted models, the estimated overall LE8 score at midlife was 2.94 points lower (95% CI, -5.13 to -0.74 points), the biomedical score was 4.07 points lower (95% CI, -7.33 to -0.78 points), and the blood subdomain score was 5.98 points lower (95% CI, -9.71 to -2.26 points) among those with vs without history of infertility. The point estimate also was lower for the behavioral domain score (β = -1.81; 95% CI, -4.28 to 0.66), although the result was not statistically significant. This cohort study of parous individuals found evidence for an association between a history of infertility and lower overall and biomedical CVH scores. Future study of enhanced cardiovascular preventive strategies among those who experience infertility is warranted.

Sex differences in cardiovascular risk factors and quality of life among individuals with hypertension in Korea from 2013 to 2018: A cross-sectional cohort study.

As its prevalence increases and its association with cardiovascular disease and mortality is established, there is a need to improve prevention and management strategies for hypertension. Therefore, we aimed to compare differences in cardiovascular health status between men and women with hypertension defined by systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg, and/or treatment with antihypertensive drugs. The association between cardiovascular health status and health-related quality of life was also evaluated. Additionally, a secondary analysis was performed on the cross-sectional data from 7306 adults with hypertension, ≥40 years of age between 2013 and 2018. Of this sample, 51.2% of patients were women from the Korean National Health and Nutrition Examination Survey. The seven Cardiovascular Health Metrics were used to quantify cardiovascular health status and the 5-dimensional European Quality of Life Questionnaire (EQ-5D) was used to evaluate health-related quality of life. A higher proportion of men than that of women was observed in the poor cardiovascular health score group [total score 0-7], with a higher proportion of women in the intermediate group [total score 8-10] and ideal group [total 11-14] (p<0.0001). The proportion of women in the EQ-5D index was higher than that of men in the poor and intermediate groups (p<0.0001), with no difference in the proportion of men and women in the ideal group (p = 0.1452). Furthermore, specific cardiovascular risk factors were different between men and women: women had lower physical activity level and higher prevalence of high cholesterol (≥200 mg/dl), and men had higher body mass indices and worse diet management. These findings indicate that prevention and management strategies for hypertension and cardiovascular health might need to differ for men and women to improve outcomes.

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.

Association between cardiovascular health and human papillomavirus infection: analysis from NHANES 2005-2016.

Given the strong association between cardiovascular disease and human papillomavirus (HPV) infection, this study aimed to assess the correlation between HPV infection and cardiovascular health (CVH) as represented by the Life's Essential 8 (LE8) score. This study employed analysis of data obtained from the National Health and Nutrition Examination Survey covering the period from 2005 to 2016. To examine the correlation between the CVH score and both HPV and high-risk HPV (HR-HPV) infections, this research utilized a combination of multivariable regression analysis, smooth curve fitting, and subgroup analysis, following adjustment for pertinent covariates. This study included a total of 8,264 women, with an average age of 39.53 ± 11.24 years. The HPV prevalence was 43.43% overall, while the HR-HPV prevalence was 17.36%. In the fully adjusted model, an augmentation of 10 points in the CVH score correlated with an 8% reduction in the HPV infection rate [0.92 (0.88-0.96)], and a similar 8% decrease in the HR-HPV infection rate [0.92 (0.87-0.97)]. Our findings indicate that elevated CVH, as denoted by higher LE8 scores, correlates with a decreased of HPV infection rate among U.S. females. The LE8 score shows potential as a shared predictive biomarker for both CVH and HPV infection.

Supplemental Material for Life Satisfaction and Ideal Cardiovascular Health Score: A Cross-Sectional Study From ELSA-Brasil

Supplemental Material for Life Satisfaction and Ideal Cardiovascular Health Score: A Cross-Sectional Study From ELSA-Brasil

Investigating how blood cadmium levels influence cardiovascular health scores across sexes and dose responses.

The association between exposure to cadmium (Cd) and cardiovascular health (CVH) has received considerable scientific interest. However, findings thus far have been inconclusive, particularly regarding sex-specific effects and dose-response relationships. The aim of our study was to investigate the relationships of blood Cd levels with the overall and component CVH scores. We used data from the 2011-2018 NHANES to assess CVH using indicators such as BMI, blood pressure, lipid profiles, glucose levels, diet, physical activity, nicotine use, and sleep quality, each rated on a 0-100 scale. The overall CVH score was calculated as the average of these indicators. We employed both multiple linear and restricted cubic spline analyses to examine the relationship between blood Cd levels and CVH scores, including nonlinear patterns and subgroup-specific effects. Our analysis revealed that higher blood Cd levels were associated with lower overall CVH, nicotine exposure, sleep, and diet scores, with nonlinear decreases observed in overall CVH and nicotine exposure scores at specific thresholds (-1.447 and -1.752 log μg/dL, respectively). Notably, sex differences were evident; females experienced more adverse effects of Cd on CVH and lipid scores, while in males, Cd exposure was positively correlated with BMI, a link not observed in females. Our study highlights the complex interplay between blood Cd levels and various aspects of CVH, revealing significant dose-response relationships and sex disparities. These findings enhance our understanding of the biobehavioral mechanisms linking Cd exposure to cardiovascular risk.

The Relationship between Cardiovascular System Health and Dementia Events at Ages 50-60 Years at Teluk Kuantan Regional Hospital

Dementia is a syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform daily activities. Several studies have shown an association between the development of cognitive impairment and dementia with educational attainment, and lifestyle-related risk factors, such as physical activity, tobacco use, unhealthy diet and harmful alcohol use. Furthermore, certain medical conditions are associated with an increased risk of developing dementia, including hypertension, diabetes, dyslipidemia, obesity and depression. The ideal cardiovascular health score, also referred to as Life's Simple 7, consists of four behavioral indicators of health, and three biologics. This study aims to determine the relationship between the health of the cardiovascular system and the incidence of dementia at the age of 50-60 years at Teluk Kuantan General Hospital. This research was carried out in an analytical nature using a cross-sectional design, which was conducted at the Teluk Kuantan Regional Hospital, in December 2020 - March 2021 and involved 70 respondents. Data obtained by medical records and interviews. Based on the results of the study, the results of the somer s d correlation test obtained p value = 0.000 (p &lt;0.05) so that there was a significant relationship between cardiovascular system health and the incidence of dementia at the age of 50-60 years. There is a Relationship between the Health of the Cardiovascular System and the Incidence of Dementia at the Age of 50-60 Years.

Association between adherence to the EAT-Lancet sustainable reference diet and cardiovascular health among European adolescents: the HELENA study.

The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health among European adolescents. Data from the HELENA study were used. Usual dietary intake was assessed using two 24-h dietary recalls and adherence to the EAT-Lancet diet was assessed using the Planetary Health Diet Index (PHDI), a 16-component index that ranges from 0 to 150 points. Cardiovascular health was assessed through the seven-component Ideal Cardiovascular Health (ICH) score: never smoked, eutrophic body mass index, moderate-to-vigorous physical activity, healthy dietary pattern, low blood pressure, low fasting plasma glucose, and low total cholesterol. Total ICH score was categorized into ideal (5-7) and non-ideal (0-4). A 10-point increment in the PHDI was associated with a lower probability of a non-ideal ICH status (OR 0.84, [95% CI: 0.75, 0.94]) among European adolescents, after adjusting for age, sex, socio-economic status, and total energy intake. Furthermore, a 10-point increment in the PHDI was associated with lower probability of high blood pressure (OR: 0.87 [0.79, 0.96]) and a lower probability of high blood cholesterol (OR: 0.88 [0.78, 0.99]). Our study suggests that a higher PHDI may be associated with a better cardiovascular health status among European adolescents.

Longitudinal cardiovascular health measured by life's essential 8 metrics with incident diabetes: A 13-year prospective cohort study.

To investigate the associations of baseline and longitudinal cardiovascular health (CVH) measured by 'Life's Essential 8' (LE8) metrics with the risk of diabetes in Chinese people with normoglycaemia or prediabetes. A total 86,149 participants without diabetes were enroled from the Kailuan study and were stratified by baseline glycaemic status (normoglycaemia or prediabetes). Cardiovascular health score ranged from 0 to 100 points was categorised into low (0-49), middle (50-79), and high (80-100) CVH status. Cox regressions were used to assess the associations of baseline and time-updated CVH status with incident diabetes in the overall cohort and across baseline glycaemic statuses. During a median follow-up of 12.94 (interquartile rage: 12.48-13.16) years, we identified 13,097 (15.20%) cases of incident diabetes. Baseline and time-updated high CVH status was associated with a lower risk of diabetes, the corresponding hazard ratio (HR) versus low CVH status was 0.27 (95% confidence interval [CI], 0.23-0.31) and 0.26 (95% CI, 0.23-0.30) in the overall cohort, respectively. Additionally, the effect of high CVH on diabetes was more prominent in participants with normoglycaemia than those with prediabetes (P<0.0001), with an HR of 0.26 (95% CI, 0.22-0.31) versus 0.50 (95% CI, 0.41-0.62) for baseline CVH, and 0.25 (95% CI, 0.21-0.30) versus 0.39 (95% CI, 0.32-0.48) for time-updated CVH. Elevated baseline and longitudinal CVH score assessed by LE8 metrics is associated with a lower risk of subsequent diabetes, especially in normoglycaemic adults.

Heart disease and stroke statistics 2023 update from the American Heart Association-implications for nephrology.

The annual American Heart Association (AHA) and National Institutes of Health statistical report details the most up to date statistics related to heart disease, stroke and cardiovascular risk factors, primarily within the USA. Although not a formal systematic review or meta-analysis, this 600 page report provides the most comprehensive and best summary of cardiovascular statistics for the year in question. Although data are collated from USA data registries, it serves as a critical resource for clinicians, policymakers, administrators and researchers in the northern and southern hemispheres. In this special report, we have chosen to highlight aspects of the document that are relevant to nephrologists, given the overlap of cardiovascular and renal disease. These include (i) key and emerging cardiovascular data signals in the general and chronic kidney disease (CKD) populations, (ii) ethnic and socio-economic disparity, (iii) environmental and behavioural factors that drive high levels of cardiovascular disease and which are key components of the AHA's eight components of the Life Essential cardiovascular health score, and (iv) the impact of COVID-19 both directly and indirectly on heart health. We provide some commentary and critical analysis of both the data and of the production of such data sets suggesting that similar data on CKD could also be published and linked to the AHA and other datasets.

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.

Cardiovascular health and the risk of Alzheimer’s dementia in a biracial population‐based study

AbstractBackgroundThe cardiovascular health (CVH) index, created by the American Heart Association (AHA) to assess and monitor the risk of cardiovascular disease, has been related to dementia risk. However, evidence is limited, and most studies originate from populations comprised of primarily white participants. We examined the association of the CVH index with the risk of incident Alzheimer’s dementia in a biracial population‐based study.MethodOur study consisted of 1,702 non‐Hispanic Black and white participants of the Chicago Health and Aging Project, a population‐based cohort. CVH was based on seven risk factors: diet, physical activity, body mass index, smoking, dyslipidemia, hypertension, and diabetes. Following AHA recommendations, we assigned points of 0, 1, or 2 based on adherence to each factor, with an overall score ranging from 0 to 14 – a higher score indicates better cardiovascular health. Clinical diagnosis of Alzheimer’s dementia was based on the NINCDS‐ADRDA criteria. Cox proportional hazard models were used to compute the hazard ratio and 95% confidence interval. Models were adjusted for age, sex, race, education, ApoE4 allele, cognitive activities, and cardiovascular disease.ResultThe average baseline age of the study population was 73 years and comprised 62% women and 53% black participants. During 14,226 person‐years of follow‐up, there were 351 incident Alzheimer’s dementia. In a multivariable‐adjusted model, CVH was linearly associated with a lower risk of incident Alzheimer’s dementia. For each additional CVH score, the HR was lower by 0.84 (95% CI 0.76 ‐ 0.94). Compared to individuals with inadequate CVH (score: 0‐6), the HRs (95% CIs) of incident Alzheimer’s dementia in participants with average (7‐9) and optimal CVH (10‐14) was 0.44 (95%CI 0.28 ‐ 0.69) and 0.37 (95%CI 0.21 ‐ 0.65), respectively. We found similar associations between CVH score, per one additional score, and risk of Alzheimer’s dementia in Black (HR 0.84, 95%CI 0.74 ‐ 0.95) and white (HR 0.83, 95%CI 0.7 ‐ 0.98) individuals.ConclusionIn a biracial cohort of older adults, the cardiovascular health burden was higher among Black individuals. However, promoting a better CVH in the general population may help lower dementia risk in Black and white older adults.

Role of Sex in the Association of Socioeconomic Status With Cardiovascular Health in Black Americans: The Jackson Heart Study.

Socioeconomic status (SES) is associated with cardiovascular health (CVH). Potential differences by sex in this association remain incompletely understood in Black Americans, where SES disparities are posited to be partially responsible for cardiovascular inequities. The association of SES measures (income, education, occupation, and insurance) with CVH scores was examined in the Jackson Heart Study. American Heart Association CVH components (non-high-density-lipoprotein cholesterol, blood pressure, diet, tobacco use, physical activity, sleep, glycemia, and body mass index) were scored cross-sectionally at baseline (scale: 0-100). Differences in CVH and 95% CIs (Estimate, 95% CI) were calculated using linear regression, adjusting for age, sex, and discrimination. Heterogeneity by sex was assessed. Participants had a mean age of 54.8 years (SD 12.6 years), and 65% were women. Lower income, education, occupation (non-management/professional versus management/professional occupations), and insurance status (uninsured, Medicaid, Veterans Affairs, or Medicare versus private insurance) were associated with lower CVH scores (all P<0.01). There was heterogeneity by sex, with greater magnitude of associations of SES measures with CVH in women versus men. The lowest education level (<high school) versus highest (>high school) was associated with 8.8-point lower (95% CI: -10.2 to -7.3) and 5.4-point lower (95% CI: -7.2 to -3.6) CVH scores in women and men, respectively (interaction P=0.003). The lowest (<25 000) versus highest level of income (≥$75 000) was associated with a greater reduction in CVH scores in women than men (interaction P=0.1142). Among Black Americans, measures of SES were associated with CVH, with a greater magnitude in women compared with men for education and income. Interventions aimed to address CVH through SES should consider the role of sex.

Cardiovascular Health Metrics Differ Between Individuals With and Without Cancer.

Although individuals with cancer experience high rates of cardiovascular morbidity, there are limited data on the potential differences in cardiovascular health (CVH) metrics between individuals with and without cancer. The National Health and Nutrition Examination Survey between 2015 and 2020 was queried to evaluate the prevalence of health metrics that comprise the American Heart Association Life's Essential 8 construct of cardiovascular health among adult individuals with and without cancer in the United States. Health metric scores were also evaluated according to important patient demographics including age, sex, race and ethnicity, and socioeconomic status. Among 4370 participants representing >180 million US adults, 9.4% had a history of cancer. Individuals with cancer had lower overall cardiovascular health scores (67.1 versus 69.1, P<0.001) compared with individuals without cancer. Among individual components of the cardiovascular health score, those with cancer had better health scores on key behaviors including physical activity, diet, and sleep compared with those without cancer, although variation was noted based on age. Higher scores on these modifiable health behaviors among those with cancer compared with those without cancer were noted in older individuals, in White individuals compared with other races and ethnicities, and in individuals with higher socioeconomic status. We highlight important variations in simple cardiovascular health metrics among individuals with cancer compared with individuals without cancer and demonstrate differences among health metrics based on age, race and ethnicity, and socioeconomic status. These findings may explain ongoing racial, ethnic, and socioeconomic status disparities in the cancer population and provide a framework for optimizing cardiovascular health among individuals with cancer.

Abstract IA038: Neighborhood factors for adiposity change and cardiovascular health among Black breast cancer survivors

Abstract Maintaining a healthy weight and cardiovascular health (CVH) after a breast cancer (BC) diagnosis is gaining clinical attention because they are essential for reducing the burden of cardiovascular disease, achieving optimal cancer survivorship, and possibly reducing mortality after a BC diagnosis. Individual behaviors and choices are largely influenced by the surrounding social and built environment; however, the neighborhood risk factors influencing post-diagnosis weight change and CVH are unclear among Black women, who have higher rates of obesity, unfavorable CVH and mortality than any other racial/ethnic group. To address this knowledge gap, we conducted analyses based on the Women's Circle of Health Follow-Up Study (WCHFS), a population-based prospective cohort of Black BC survivors in New Jersey. In the first analysis, adiposity changes during the period ~10 months to 2 years after diagnosis were evaluated among 785 women enrolled in the WCHFS. We found that despite a high baseline prevalence of overweight or obesity, weight gain was common. Greater density of fast-food restaurants and lower walkability were identified as neighborhood-level risk factors for weight gain. We also showed that intentional weight loss was much less common than weight gain, and its neighborhood risk factors were considerably different from unintentional weight loss. In a subsequent analysis, we aimed to capture the complex interplay between neighborhood features through neighborhood archetype analysis based on 16 social and built environment features, and to estimate their associations with CVH around 2 years after diagnosis among Black women. The CVH index used American Heart Association definition and scoring criteria for BMI, diet, smoking, physical activity, blood pressure, cholesterol, glucose, and sleep. We found that Black BC survivors, on average, reached only half of the recommended optimal CVH score, and no participant met all ideal CVH metrics. Among the four neighborhood archetypes identified, we found that the archetype associated with the most favorable post-diagnostic CVH was characterized by diverse racial and ethnic populations, a higher neighborhood socioeconomic status, greater densities of restaurants, food stores, physical activity facilities, walkable destinations, and ambulatory care. However, only 16% of our participants lived in this type of neighborhood. In summary, our work revealed that residential environments may considerably impact adiposity change and CVH among Black BC survivors. Through these studies, we provided insights into the distinct neighborhood characteristics and archetypes that may influence BC survivorship for Black women. Recognizing that social determinants of health act at multiple levels, domains, and factors, it is crucial that future research comprehensively investigates neighborhood and other multilevel determinants to identify the specific social barriers that must be addressed to achieve the most measurable improvements in BC survivorship for Black women. Citation Format: Bo Qin, Carola T. Sánchez-Díaz, Hari S. Iyer, Noreen Goldman, Nur Zeinomar, Andrew G. Rundle, Christine B. Ambrosone, Kitaw Demissie, Chi-Chen Hong, Gina S. Lovasi, Elisa V. Bandera. Neighborhood factors for adiposity change and cardiovascular health among Black breast cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr IA038.

Life’s Essential 8, genetic predisposition, and risk of incident adult-onset asthma: a prospective cohort study

BackgroundAdult-onset asthma (AOA) and cardiovascular diseases shared common risk factors and similar pathophysiologic resemblances. The American Heart Association (AHA) unveiled the life’s essential 8 (LE8) to promote cardiovascular health (CVH). This study aimed to assess the overall impact of LE8 implementation on AOA prevention. MethodsAccording to the guideline of AHA’s Construct of CVH in 2022, LE8 score was calculated from 8 health status concerning diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional-hazards models were used to estimate effect sizes of associations between CVH, asthma genetic risk, and risk of incident AOA in participants selected from the UK Biobank study. ResultsA total of 6180 incident AOA cases occurred in 249,713 participants during an average of 11.60 y’ follow-up. A higher LE8 score was associated with a lower risk of incident AOA with a significant linear trend (P < 0.0001). Every standard deviation increment of LE8 was associated with a 17% (HR: 0.83; 95% CI: 0.81, 0.85) lower risk of incident AOA. Compared with participants with low-CVH score, participants with moderate (HR: 0.72; 95% CI: 0.67, 0.78) and high CVH scores (HR: 0.52; 95% CI: 0.47, 0.58) were associated with a lower risk of incident AOA (P-trend < 0.0001). No significant multiplicative or additive interaction was found between LE8 score and genetic risks. Stratified analysis showed a consistent association between CVH and risk of incident AOA across different asthma polygenic risk score (PRS) levels. Compared with participants with high PRS and low CVH, participants with low PRS and high CVH experienced the lowest risk (HR: 0.28; 95% CI: 0.23, 0.34) of incident AOA. ConclusionsOur findings suggest that maintaining optimal CVH should be recommended as a preventive strategy for AOA, regardless of their asthma genetic risks.

Baseline and longitudinal cardiovascular health using Life’s Essential 8 metrics with the risk of incident hypertension

ABSTRACT Objective The quantification of cardiovascular health (CVH) was updated by the American Heart Association recently by using the “Life’s Essential 8” (LE8) score. We aimed to investigate the associations of baseline and longitudinal CVH status measured by the new LE8 score (except for blood pressure) with the risk of hypertension. Methods A total of 52 990 participants with complete data on LE8 metrics and without hypertension were enrolled from the Kailuan study, Tangshan, China. The associations of incident hypertension with the overall baseline, time-updated, and time-varying CVH score (ranging 0 [lowest] to 100 [highest]), and each component of LE8, were assessed by Cox regressions. Results During a median follow-up of 10.73 years 28 380 cases of incident hypertension were identified. The risk of hypertension attenuated with increased CVH score (Ptrend < 0.0001), the hazard ratios (HRs) in high CVH versus low CVH group was 0.54 (95% confidence interval [CI], 0.51–0.57) for baseline CVH, 0.47 (95% CI, 0.45–0.50) for time-updated CVH, and 0.59 (95% CI, 0.55–0.63) for time-varying CVH. The predictive value of CVH in predicting hypertension improved by using LE8 than using Life’s Simple 7 metrics. Among LE8 components, body mass index score was the strongest risk factor for hypertension. Subgroup analyses showed that the benefit of a higher CVH score on hypertension was more prominent in young adults and in women (Pinteraction < 0.05). Conclusions A higher CVH score assessed by new LE8 is associated with a lower risk of subsequent hypertension, especially young adults and women.

Association of Cardiovascular Health with Cognitive Function in US Older Adults: A Population-Based Cross-Sectional Study.

Promoting cardiovascular health (CVH) by Life's Simple 7 is associated with better cognitive function. In 2022, the American Heart Association (AHA) prompted Life's Essential 8 (LE8) to strengthen CVH assessment. This study investigated the association between the new CVH metrics assessed by LE8 and cognitive function, thus providing evidence for implementing LE8 in the primordial prevention of cognitive impairment. 2,050 participants aged 60 and older from National Health and Nutrition Examination Survey 2011-2014 were included. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The overall and domain-specific cognitive function z-score was created. CVH score was calculated following AHA's advisory. The multivariable linear regression model estimated the associations. The CVH score assessed by LE8 was independently, positively, and linearly associated with the overall cognitive function. A per-10 point increase in CVH was associated with higher overall cognitive z-scores (β, 0.06; 95% confidence interval [CI], 0.03, 0.09), and participants with moderate (β, -0.14; 95% CI, -0.22, -0.05) and low CVH (β, -0.27; 95% CI, -0.37, -0.16) had lower overall cognitive z-scores compared to participants with high CVH. Similar patterns of associations were observed between CVH of AFT and DSST. Components of CVH were further associated with different domain-specific cognitive functions. Maintaining an ideal CVH improves cognitive function in older adults. Ideal adherence to individual components of LE8 was associated with improved overall and domain-specific cognitive functions. Therefore, promoting CVH according to LE8 might benefit cognitive function in the elderly.

Prevalence of cardiometabolic risk and health factors among Puerto Rican young adults in the Boricua Youth Study – Health Assessment

We describe and compare the prevalence of cardiometabolic risk factors and ideal cardiovascular health (CVH) among Puerto Rican young adults in the San Juan metro area in Puerto Rico and the South Bronx, NY. As part of the Boricua Youth Study – Health Assessment, (mean age 23±0.1 years) objective anthropometric, blood pressure and blood samples were collected. Information on diet, physical activity and sleep were collected via surveys. Life’s Essential 8 metrics were characterized as continuous with higher scores indicating more optimal CVH and categorically (80-100 scores for ideal CVH). Mean CVH score among NY participants was lower (61.9) than in PR (68.9). No participant had all ideal health metrics, 36% of participants in PR had 5 or more ideal CVH; while only 16% in NY met this criterion. The prevalence of cardiometabolic risk factors was high for obesity (35% in NY, 19% in PR) and diabetes (17% NY, 20% PR). In this ethnically homogenous population, we found low levels of ideal CVH that varied across study site, suggesting differences by sociocultural context. Interventions to maintain and improve CVH across the life course, tailored to sociocultural environments, are necessary for the prevention of cardiovascular disease.

Association between psychological distress and cardiovascular health amongst cancer survivors in the United States: findings from nationally representative data

Abstract Background Although both psychological distress and cancer are associated with worse cardiovascular health, the associations between psychological distress and cardiovascular health in cancer survivors are unclear and requires delineation, especially as the number of long-term cancer survivors increases. Purpose To investigate the relationship between psychological distress and cardiovascular health amongst cancer survivors. Methods This cross-sectional study used data from the 2013-2017 National Health Interview Survey, an annual survey representative of the non-institutionalized population of the United States. Subjects with missing data for any of the exposure, outcome, or covariates were excluded. Psychological distress was measured by the six-item Kessler scale (K6), and severe psychological distress (SPD) was defined as K6 ≥13. Cardiovascular health (CVH) was quantified based on the American Heart Association’s Life’s Essential Eight. As dietary data was unavailable, the score included seven binary items (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity, inadequate sleep, and obesity), with higher scores indicating worse CVH. Multivariable Poisson regression was used to test associations between SPD and CVH, adjusting for the presence of any known cardiac condition, family income, education level, race, sex, sexual orientation, insurance coverage, and age. Results Altogether, 138,001 subjects (weighted population of 203,223,831) were analysed, of whom 13,485 (weighted population of 17,648,471) were cancer survivors. SPD was independently associated with worse cardiovascular health both in cancer survivors (adjusted risk ratio (aRR) 1.24 [95% confidence interval: 1.19, 1.29], p&amp;lt;0.001) and those without known cancer (aRR 1.41 [1.39, 1.44], p&amp;lt;0.001), but the association was weaker in the former (pinteraction=0.001). The relationships were grossly linear in both groups of patients (Figure 1). Amongst cancer survivors, SPD was independently associated with all components of the cardiovascular health score except obesity (all p&amp;lt;0.05). Furthermore, amongst cancer survivors, the association was stronger in those who were younger (pinteraction&amp;lt;0.05) or female (pinteraction=0.014), but did not differ significantly by family income, race, or the presence of known cardiac conditions (Figure 2). The association remained significant for most cancer sites. Conclusions and relevance SPD was associated with worse cardiovascular health amongst cancer survivors, especially young, female patients, although the association was weaker than that in non-cancer subjects. These highlighted the importance of a multidisciplinary approach with careful psychological assessments in the care of cancer survivors, while shedding light on the patients who may benefit most from future quality improvement programs.Figure 1Figure 2