Moderate Cardiovascular Health Research Articles

Poor healthy lifestyle and life's essential 8 are associated with higher risk of new-onset migraine: a prospective cohort study.

Lifestyle are closely related to migraine. However, there is a lack of studies investigating the association between Healthy lifestyle or Life's Essential 8 (LE8) and the risk of migraine. The objective of this research was to investigate the relationship between Healthy lifestyle scores and Life's essential 8 scores, and migraine. 332,895 UK Biobank participants without migraine were included. Healthy lifestyle were assessed using seven lifestyle factors, and categorized as poor, intermediate, or ideal. LE8, based on the American Heart Association (AHA) Guidelines for Cardiovascular Health (CVH), consist of eight indicators classified as low, moderate, or high CVH. The Cox proportional hazard model was employed to examine the association between Healthy lifestyle scores, LE8 scores, and migraine, with calculations for population-attributable fraction (PAF) and cumulative incidence. During a median follow-up of 13.58 years, participants in intermediate (HR: 0.91; 95% CI: 0.85, 0.99) or ideal category of Healthy lifestyle (HR: 0.81; 95% CI: 0.73, 0.91) significantly reduced migraine risk compared to the poor category. Similarly, high CVH (HR: 0.73; 95% CI: 0.58, 0.92) also lowered migraine risk, while moderate CVH (HR: 0.93; 95% CI: 0.85, 1.02) did not show a difference compared to low CVH. If all individuals adhered to higher categories of Healthy lifestyle and LE8, approximately 11.38% and 22.05% of migraine cases could be prevented. Among individual lifestyle factors, maintaining an ideal body mass index (BMI), physical activity, sleep duration, sleep pattern, and sedentary time were associated with substantial reductions in migraine risk, by 5.65%, 0.81%, 10.16%, 16.39%, and 6.57%, respectively. Our study provides evidence that poor Healthy lifestyle and Life's Essential 8 are associated with higher risk of new-onset migraine.

Maternal cardiovascular health in early pregnancy and the risk of congenital heart defects in offspring

BackgroundCongenital heart disease (CHD) is the predominant birth defect. This study aimed to explore the association between maternal cardiovascular health (CVH) and the CHD risk in offspring.MethodsWe used the prospective data from the Fujian Birth Cohort Study, collected from March 2019 to December 2022 on pregnant women within 14 weeks of gestation. Overall maternal CVH was assessed by seven CVH metrics (including physical activity, smoking, sleep duration, body mass index, blood pressure, total cholesterol, and fasting plasma glucose), with each metric classified as ideal, intermediate or poor with specific points. Participants were further allocated into high, moderate and low CVH categories based on the cumulative CVH score. The association with offspring CHD was determined with log-binominal regression models.ResultsA total of 19810 participants aged 29.7 (SD: 3.9) years were included, with 7846 (39.6%) classified as having high CVH, 10949 (55.3%) as having moderate CVH, and 1015 (5.1%) as having low CVH. The average offspring CHD rate was 2.52%, with rates of 2.35%, 2.52% and 3.84% across the high, moderate and low CVH categories, respectively (P = 0.02). Adjusted relative risks (RRs) of having offspring CHD were 0.64 (95% CI: 0.45-0.90, P = 0.001) for high CVH and 0.67 (95% CI: 0.48-0.93, P = 0.02) for moderate CVH compared to low CVH. For individual metrics, only ideal total cholesterol was significantly associated with lower offspring CHD (RR: 0.73, 95% CI: 0.59-0.83, P = 0.002).ConclusionsPregnant women of high or moderate CVH categories in early pregnancy had reduced risks of CHD in offspring, compared to those of low CVH. It is important to monitor and improve CVH during pre-pregnancy counseling and early prenatal care.

Abstract P396: Life’s Essential 8 Cardiovascular Health Metrics Are Deteriorating In South Korea: A Nationwide Survey 2007-2021

Introduction: The American Heart Association (AHA) recently updated the “Life’s Essential 8” (LE8) metrics for quantification of cardiovascular health (CVH). We investigated temporal trends of CVH status by LE8 metrics among Korean adults, using nationwide survey data. Methods: We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007-2021, including 93,092 participants aged 20 years or older. The LE8 CVH score was calculated as the average score of 8 metrics: diet, physical activity, nicotine exposure, sleep health, body mass index (BMI), blood lipids, blood glucose, and blood pressure, each scaled 0 to 100 points. The CVH scores of 80 to 100 were categorized as high CVH, 50 to <80 as moderate CVH, and 0 to <50 as low CVH. All statistical analyses accounted for the complex survey design of the KNHANES data. Results: From the 4 th (2007-2009) to 8 th (2019-2021) cycle of the KNHANES, the mean LE8 CVH score declined from 68.9 to 66.6 in the Korean population. The proportion of adults with high CVH decreased from 22.5% to 16.9%, while the proportion of adults with low CVH increased from 8.4% to 10.6% (Figure A). Most adults had already lost ideal CVH by young adulthood; only 25% of adults aged 20-39 attained high CVH, and the proportion was lower at older ages. By individual metrics (Figure B), the score decreased in terms of physical activity (51.2 to 32.8), BMI (77.3 to 74.2), blood lipids (70.1 to 65.9), blood glucose (87.5 to 82.0), and blood pressure (75.9 to 72.3), remained stable in terms of sleep health (80.7 to 80.8), and increased in terms of diet (46.7 to 52.0) and nicotine exposure (63.6 to 73.3). The time-trends were similar across sex and age groups, although CVH scores were generally lower among men and older age. Conclusions: The CVH status of Korean adults has deteriorated over the past 15 years, especially in terms of physical activity, BMI, blood lipids, blood glucose, and blood pressure.

Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20-year follow-up was 7.43 per 1000 person-years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40-0.68) and 0.25 (95% CI, 0.14-0.44), respectively, after adjustment for age, sex, education, and study site. Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.

Comparison of the associations between Life's Essential 8 and Life's Simple 7 with depression, as well as the mediating role of oxidative stress factors and inflammation: NHANES 2005–2018

BackgroundCardiovascular health (CVH) is closely associated with depression. However, Life's Essential 8 (LE8), a novel CVH measure, has not yet been clearly linked to depression. This study aims to explore the association between LE8 and depression, compare its advantages over Life's Simple 7 (LS7), and investigate the mediating effects of oxidative stress and inflammation. MethodsThis study investigated cross-sectional data of adults aged 20 and above from National Health and Nutrition Examination Survey (NHANES) 2005 to 2018. The LE8 score (ranging from 0 to 100) was derived from the American Heart Association's definition, based on the unweighted average of 8 metrics, classified as low cardiovascular health (CVH) (0–49), moderate CVH (50–79), and high CVH (80–100). Similar to LE8, LS7 scores were categorized into inadequate (0–7), average (8–10), or optimal (11–14) after calculating the unweighted mean of each component. Depression was diagnosed using the Patient Health Questionnaire (PHQ-9), with a score of ≥10 defining depression. Adjusted for sociodemographic factors and other risk factors for depression, weighted logistic regression and restricted cubic spline analysis were used to explore the correlation. Receiver operating characteristic (ROC) curves were used to study the associations between CVH scores and depression. Subsequently, subgroup analysis and sensitivity analysis were conducted, followed by an exploration of the mechanisms involved. ResultsA total of 7 cycles from 2005 to 2018 contained complete data. Weighted logistic regression showed that both LS7 and LE8 were significantly associated with depression. Specifically, for LE8, after adjustment, the risk of depression decreased by 52 % for moderate CVH compared to low CVH (OR: 0.48, 95 % CI: 0.41–0.57, P < 0.0001), while the risk decreased by 80 % for high CVH (OR: 0.20, 95 % CI: 0.15–0.26, P < 0.0001, Ptrend < 0.0001). For LS7, after adjustment, compared with inadequate CVH, the risk of depression decreased by 49 % for average CVH (OR: 0.51, 95 % CI: 0.34–0.78, P = 0.002), and by 55 % for optimal CVH (OR: 0.45, 95 % CI: 0.27–0.74, P = 0.002, Ptrend < 0.0001). Area under ROC curves for predicting depression were 0.672 (95 % CI, 0.66–0.684; P < 0.001) and 0.605 (95 % CI, 0.59–0.619; P < 0.001) for LE8 and LS7 (PDeLong < 0.001), respectively. Sensitivity analysis demonstrated the robustness of the association. GGT and WBC jointly mediated 9.62 % of this association (all P < 0.001). LimitationsThe cross-sectional study cannot infer causality. ConclusionsThe association between Life's Essential 8 and depression was stronger and more practical. Oxidative stress and inflammation mediate this association. Individuals with extremely poor cardiovascular health have a 7-fold increased risk of depression, highlighting the necessity of maintaining at least moderate cardiovascular health.

The association between Life's Essential 8 and all-cause, cancer and non-cancer mortality in US Cancer Survivors: A retrospective cohort study of NHANES

ObjectiveTo investigate Life's Essential 8 (LE8), a measure of cardiovascular health (CVH), associations with mortality outcomes in cancer survivors. MethodsA prospective cohort study included 1818 cancer survivors aged ≥20 years (weighted population: 13,204,583) from National Health and Nutrition Examination Survey (NHANES) 2005–2018. Linked to mortality data through 2019, LE8 data were gathered through self-reports and lab tests. An LE8 score of 80–100 is considered high CVH, 60–79 is moderate CVH, and 0–59 is low CVH. Multivariable Cox proportional hazards regression models were employed to evaluate the associations between LE8 and all-cause, cancer-specific and non-cancer mortality. Subsequently, subgroup analyses were conducted to assess the relationship between LE8 and mortality rates across various subgroups. ResultsAt baseline, there were 1818 cancer survivors. In a 15-year follow-up, 2548 deaths occurred: 601 from cancer, 647 from heart disease, and 1300 from other causes. Multivariable models showed high CVH associated with lower hazard ratios for all-cause, cancer-specific and non-cancer mortality vs. low CVH. Cumulative mortality rates increased during follow-up, more so in the low CVH group. Subgroup analysis revealed significant LE8 interactions with age or Poverty Income Ratio (PIR) for all-cause mortality. Additionally, significant interactions between LE8 and PIR were identified for cancer-specific and non-cancer mortality risks (P for interaction <0.05). ConclusionAmong U.S. cancer survivors, higher CVH is independently linked to lower all-cause, cancer-specific, and non-cancer mortality risks. The new CVH definition shows promise as a primary prevention strategy to reduce mortality rates in U.S. cancer survivors.

Ideal cardiovascular health and cardiovascular related events: a systematic review and meta-analysis.

The aim of this study was to systematically review and quantitatively summarise the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVD) and cardiometabolic diseases (CMD). EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias. Data were analysed with a random-effect meta-analysis. This meta-analysis included 59 studies (1,881,382 participants). Participants with ideal CVH had a considerably lower risk of a variety of CVDs and CMDs as compared to those with poor CVH, varying from 40% lower risk for atrial fibrillation (AF) (HR = 0.60 [95% CI 0.44-0.83]) to 82% lower risk for myocardial infarction (HR = 0.18 [95% CI 0.12-0.28]). Intermediate CVH was associated with 27%-57% lower risk in CVDs and CMDs compared to poor CVH, with the highest hazard for AF (HR = 0.73 [95% CI 0.59-0.91]), and the lowest hazard for peripheral arterial disease (HR = 0.43 [95% CI 0.30-0.60]). Ideal and moderate CVH were associated with a lower incidence of CVDs and CMDs than poor CVH. LS7 holds significant potential for promoting overall CVH and thereby contributing to the prevention of CVDs.

The association between cardiovascular health and depression: Results from the 2007–2020 NHANES

BackgroundLimited research has been conducted on the correlation between Life's Essential 8 (LE8), the recently updated algorithm for evaluating cardiovascular health (CVH), and depression. MethodsA total of 21,942 individuals were chosen from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2020. The depression was determined using the Patient Health Questionnaire (PHQ-9), with a score of 10 or higher indicating diagnosis. The LE8 score consists of 8 metrics: sleep health, diet, physical activity, nicotine exposure, body mass index, blood lipids, blood glucose, and blood pressure. Each LE8 metric was scored from 0 to 100 points. The summation of all metrics divided by 8 generated the total LE8 score and was categorized into low (0–49), moderate (50–79), and high (80–100) CVH. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the association between LE8 score and depression. ResultsA significant inversely nonlinear relationship was observed between LE8 score and depression. When compared to participants with high CVH, those with moderate CVH had multivariable adjusted odds ratios (ORs) for depression of 2.36 (95 % CI, 1.79–3.10), while those with low CVH had ORs of 4.71 (95 % CI, 3.44–6.47). Moreover, the effect size of the LE8 score on depression remained stable in all pre-specified subgroups, with all P-values for interaction being more than 0.05. ConclusionsThe results indicate a significant inversely nonlinear relationship between LE8 score and depression, particularly among males. These findings emphasize the importance of maintaining higher CVH as a preventive measure against depression.

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.

Temporal Trends in Cardiovascular Health Status Among Chinese School-Aged Children From 1989 to 2018: Multiwave Cross-Sectional Analysis.

Despite the release of updated metrics for Life's Essential 8 (LE8), key indicators for assessing cardiovascular health (CVH) status, there is currently no report on their distribution among Chinese children. This study aimed to assess the nationwide distribution of CVH in Chinese school-aged children using LE8 scores and analyze temporal changes in these scores over time. Participants aged 7 to 19 years from 11 waves (between 1989 and 2018) of the China Health and Nutrition Survey were included in this study. LE8 components were grouped into 2 domains of health behaviors (diet, physical activity, nicotine exposure, sleep) and health factors (BMI, blood lipids, blood glucose, blood pressure). Scores of overall CVH and each LE8 metric were calculated individually. Temporal changes were assessed with joint point regression models by rural and urban living residence. The causal relationships between health behaviors and health factors that changed the most over time were built with cross-lagged panel models. A total of 21,921 participants, 52.6% (n=11,537) of whom were male, who had data for at least 4 CVH components were included in the analysis. The mean age was 13 (SD 3.6) years. The overall CVH score remained stable in most regions, with the lowest found in Shandong from East China, which had a mean between 67 (SD 10.9) and 67.2 (SD 12.4). In contrast, the highest score was found in Guizhou from Southwest China, with a mean between 71.4 (SD 10.8) and 74.3 (SD 10.3). In rural areas, the diet score decreased significantly from 1997 onward with a speed of 0.18 (95% CI: 0.15-0.21; P<.001) per year, and the BMI score decreased significantly from 2005 onward with a speed of 0.56 (95% CI 0.44-0.68; P<.001) per year. In urban areas, the diet score decreased from 1994 onward with a speed of 0.03 (95% CI: 0.001-0.07; P=.04) per year, and the BMI score decreased from 2002 onward with a speed of 0.63 (95% CI 0.47-0.79; P<.001) per year. The sleep score dropped constantly in both urban and rural areas, with a speed of 0.69 (95% CI 0.58-0.80; P<.001) and 0.69 (95% CI: 0.52-0.86; P<.001) per year, respectively. A decline in the diet score led to a decline in the BMI score with a coefficient of 0.190 (95% CI 0.030-0.351; P=.02), while a decline in the BMI score led to a decline in sleep health with a coefficient of 0.089 (95% CI 0.010-0.168; P=.03). Chinese school-aged children and adolescents were generally of moderate CVH status, but mutual influences existed between CVH metrics. Dietary interventions should be prioritized for promoting overall CVH in the future.

Oxidative Stress Factors Mediate the Association Between Life's Essential 8 and Accelerated Phenotypic Aging: NHANES 2005-2018.

Cardiovascular health (CVH) is a well-known predictor of morbidity and mortality, while phenotypic age (PhenoAge) is a promising biomarker of aging. This study aimed to explore the association between Life's Essential 8 (LE8), a novel CVH measure, and PhenoAge acceleration (PhenoAgeAccel), as well as the potential mediating role of oxidative stress biomarkers in this relationship. A total of 23 896 individuals were included in the National Health and Nutrition Examination Survey database (2005-2018). Life's Essential 8 scores were categorized into low, moderate, and high groups. PhenoAge, measured through clinical laboratory blood chemistries, served as a marker of biological aging. Weighted linear regression analyses were performed to assess the association between LE8 scores and PhenoAgeAceel. In the multivariable linear regression, LE8 scores were significantly and inversely associated with PhenoAgeAccel, showing a decreased risk in the moderate CVH group (β -2.98; 95% CI -3.29, -2.66) and high CVH group (β -4.72; 95% CI -5.08, -4.35) compared to the low CVH group. When treated as a continuous variable, each 10-point increase in LE8 scores corresponded to a 1.14-year decrease in PhenoAge (β -1.14; 95% CI -1.21, -1.06). Among the 8 individual components in LE8, 7 exhibited a significant negative correlation with PhenoAgeAccel, except for blood lipids. Additionally, mediation analysis revealed that oxidative stress biomarkers, including γ-glutamyltransferase, bilirubin, and uric acid, collectively mediated 17.1% of the associations between LE8 scores and PhenoAgeAccel (p < .001). Higher LE8 scores, representing ideal CVH, are significantly related to a deceleration in PhenoAge, and oxidative stress biomarkers may play a mediating role in this relationship.

Association between updated cardiovascular health construct and risks of non-alcoholic fatty liver disease

Background and aimsThe American Heart Association (AHA) updated the construct and algorithm of cardiovascular health (CVH) recently. We aimed to explore the relationship between the new CVH score and the development of non-alcoholic fatty liver disease (NAFLD). Methods and results3266 adults free of NAFLD identified via ultrasound were recruited in this prospective study. A modified AHA “Life's Essential 8” (mLE8, i.e., physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure) were collected to evaluate the CVH score. Then participants were categorized into low, moderate, and high CVH subgroups based on overall mLE8 CVH score. According to modified Life's Simple 7 (mLS7) CVH construct, participants were also subdivided into poor, intermediate, and ideal CVH subgroups. During a median 4.3 years follow-up, 623 incident cases of NAFLD were recorded. Compared to those with high CVH, participants with low CVH (adjusted OR = 2.56, 95% CI 1.55–4.24) and moderate CVH (adjusted OR = 1.83, 95% CI 1.17–2.85) had a significantly increased risk of incident NAFLD. Participants with poor CVH (mLS7) but without low CVH (mLE8) did not show a significant elevated risk of incident NAFLD (P = 0.1053). A significant trend was found between increased changes in mLE8 score and a lower risk of NAFLD occurrence. ConclusionOur findings suggested high mLE8 CVH score was associated with a lower risk of NAFLD incidence. The new CVH construct showed a more reasonable classification of CVH status and was more robust in association with NAFLD risks compared with the original one.

Adherence to Life’s Essential 8 and incident chronic kidney disease: a prospective study of 147,988 UK Biobank participants

BackgroundThe American Heart Association recently updated Life’s Essential 8 (LE8) score. This amalgamation of health factors, recognized for their individual associations with chronic kidney disease (CKD) risk, provides a robust tool to assess overall cardiovascular health (CVH), which could potentially be extrapolated to predict CKD risk. ObjectivesThis study aimed to investigate the association between levels of CVH, as measured by the LE8 score, and risk of CKD in the UK Biobank. MethodsA total of 147,988 participants free of CKD and cardiovascular disease from the UK Biobank were included in this prospective study. CVH levels were categorized as low (0–49), moderate (50–79), and high (80–100) using LE8 score. An adjusted Cox proportional hazard model was used to investigate the association between LE8 and CKD. The population attributable-risk (PAR) was also calculated. ResultsDuring a median follow-up of 10 y, 1936 CKD cases were documented. A higher LE8 score was associated with a significant lower risk of CKD (P < 0.001), and a linear dose–response relationship was observed. Similar patterns were also found in the associations of the LE8 behavior and biological subscale scores with CKD. Compared with participants with a low CVH category, participants with a moderate CVH were associated with a 39% lower risk of developing CKD (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.52, 0.72); and those with a high CVH had a 57% lower risk of CKD incidence (HR: 0.43; 95% CI: 0.35, 0.53) after adjustment for covariates. Among 8 distinct metrics of LE8 score, the BMI metric had the highest PAR (24.6%; 95% CI: 18.8, 30.2). Of the total CKD risk, 3.2% (95% CI: 1.4, 5.0) was attributable to inadequate or excessive sleep duration. ConclusionsHigh CVH, defined by LE8, is significantly associated with a lower risk of CKD. These results suggest that promoting optimal cardiovascular health may lower the burden of CKD.

Life’s Essential 8 and Mortality in US Adults with Chronic Kidney Disease

Introduction: The current prevalence of chronic kidney disease (CKD) is substantial, and CKD individuals face a heightened risk of mortality, encompassing both all-cause and cause-specific outcomes. The current study aims to investigate the potential impact of adhering to Life’s Essential 8 (LE8) on reducing mortality among CKD individuals. Methods: Using the National Health and Nutrition Survey (NHANES) data from 2005 to 2018, we analyzed 22,420 US adults (≥20 years old). CKD is defined by urinary albumin-to-creatinine ratio (≥30 mg/g or 3 mg/mmol) and estimated glomerular filtration rate (<60 mL/min/1.73 m²). The components of LE8, including diet, physical activity (PA), nicotine exposure, sleep, body mass index, blood lipids, blood glucose, and blood pressure (BP), were measured and given a score of 0–100. The total LE8 score was the unweighted average of all components and was divided into low cardiovascular health (CVH) (0–49), moderate CVH (50–79), and high CVH (80–100). A Cox proportional hazards regression model was used to explore the associations of LE8 with all-cause, cardiovascular disease (CVD), and cancer mortality, which were followed prospectively by the National Center for Health Statistics until December 31, 2019. Results: In the overall population, individuals with moderate CVH had a 47% lower risk of CKD, while high CVH was linked to a 55% lower risk compared to low CVH. During a median follow-up of 7.58 years, CKD individuals had a 93% higher all-cause mortality rate and a 149% higher CVD mortality rate compared to those without CKD. Among the CKD individuals, every 10-point increase in the LE8 score was associated with reduced risks of 17% for all-cause mortality (especially PA, nicotine exposure, blood glucose, and BP), 18% for CVD mortality (especially PA), and 12% for cancer mortality (especially PA and sleep health). In additional and sensitivity analysis, the results remained significant after further consideration of potential confounding of renal function. Additionally, LE8 demonstrated superior risk stratification for CVD mortality among CKD patients compared with LS7. Interaction was observed between LE8 and age, education level, marital status, and drinking status. Conclusion: The current study demonstrates that adherence to higher LE8 levels within CKD individuals is associated with a reduced risk of both all-cause and cause-specific mortality.

1389-P: Life’s Essential 8, Socioeconomic Status, and Incidence of Nonalcoholic Fatty Liver Disease

Background: The American Heart Association (AHA) recently released a new cardiovascular health (CVH) metric, Life’s Essential 8 (LE8). Nonalcoholic fatty liver disease (NAFLD) shares many common risk factors with cardiovascular disease. We aim to analyze the relationship between LE8 and the risk of NAFLD; and assess the modification effects of socioeconomic status and genetic susceptibility. Methods: We prospectively analyzed the association between LE8 and the risk of NAFLD among 141,504 participants from the UK Biobank. LE8 was defined by the AHA algorithm and categorized into low (0-49), moderate (50-79), and high (80-100) CVH. Results: A higher LE8 score was associated with a significantly lower risk of NAFLD (p&amp;lt;0.001). Compared to individuals with a low CVH, the HR (95% CI) was 0.40 (0.34, 0.47) for those with a moderate CVH, and 0.12 (0.09, 0.16) for those with a high CVH. Townsend deprivation index (TDI) and education level modified the association between LE8 and NAFLD (p-int&amp;lt;0.001 for TDI and p-int=0.003 for education, Figure). The protective associations were more pronounced among those less deprived and those with higher education. Moreover, we observed a significant interaction between LE8 and genetic predisposition to NAFLD (p-int=0.023). Conclusion: Adherence to a high LE8 is associated with a lower risk of NAFLD. Such relationships are modified socioeconomic status or lower genetic risk. Disclosure X. Li: None. Q. Xue: None. H. Ma: None. X. Wang: None. H. Feng: None. Y. Heianza: None. L. Qi: None. Funding National Heart, Lung, and Blood Institute (HL071981, HL034594, HL126024); National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, DK100383); Fogarty International Center (TW010790)

1314-P: Adherence to Life’s Essential 8 and Incident Chronic Kidney Disease—A Prospective Study of 142,567 UK Biobank Participants

Background: The American Heart Association (AHA) recently updated an improved method for evaluating cardiovascular health (CVH): Life’s essential 8 (LE8). We aimed to investigate the association between levels of CVH and the risk of CKD in UK biobank. Methods: A total of 142,567 participants free of CKD and CVD were included. LE8 score at baseline was created including DASH diet, physical activity, smoking, sleep, BMI, non-HDL cholesterol, HbA1c, and BP. CVH levels were categorized as low, moderate, and high. Cox proportional hazard model was used to investigate the association between LE8 and CKD. Results: During a median follow-up of 11.8 years, 4,914 CKD cases were documented. We observed a linear dose-response relationship. Compared to participants with a low CVH, those with a moderate CVH were associated with a 35% lower risk of developing CKD (HR=0.65, 95% CI: 0.59, 0.73). Participants with a high CVH had a 48% lower risk of CKD incidence (HR=0.52, 95% CI: 0.45, 0.60) after adjustment for covariates. Additionally, the HR (95% CI) for each SD increment in behavior subscale score was 0.46 (0.39, 0.53) for CKD, and the HR (95% CI) for each SD increment in biological subscale score was 0.86 (0.76, 0.98) for CKD. Conclusion: Participants with high CVH, defined by LE8, were significantly associated with a lower risk of CKD. The burden of CKD may be reduced by promoting adherence to optimal CVH levels. Disclosure R.Tang: None. X.Wang: None. X.Li: None. H.Ma: None. Y.Heianza: None. L.Qi: None.

Validation of "Life's Essential 8" Metrics With Cardiovascular Structural Status in Children: The PROC Study in China.

Background Life's Essential 8 (LE8) metrics for cardiovascular health (CVH) aid primordial prevention in US populations. Methods and Results We conducted a child cohort study (PROC [Beijing Child Growth and Health Cohort]) with baseline (2018-2019) and follow-up (2020-2021) assessments, enrolling disease-free 6- to 10-year-old children from 6 elementary schools in Beijing. We collected LE8-assessed components via questionnaire surveys and 3 cardiovascular structural parameters by 2-dimensional M-mode echocardiography: left ventricular mass (LVM), LVM index, and carotid intima-media thickness. Compared with 1914 participants (mean age, 6.6 years) at baseline, we saw lower mean CVH scores at follow-up (n=1789; 8.5 years). Among LE8 components, diet presented the lowest perfect-score prevalence (5.1%). Only 18.6% of participants had physical activity ≥420 min/wk, 55.9% had nicotine exposure, and 25.2% had abnormal sleep duration. Prevalence of overweight/obesity was 26.8% at baseline and 38.2% at follow-up. We noted optimal blood lipid scores in 30.7%, while 12.9% of children had abnormal fasting glucose. Normal BP was 71.6% at baseline and 60.3% at follow-up. LVM (g), LVM index (g/m2.7), and carotid intima-media thickness (mm) were significantly lower in children with high (56.8, 33.2, 0.35) or moderate CVH scores (60.6, 34.6, 0.36), compared with children with low CVH scores (67.9, 37.1, 0.37). Adjusting for age/sex, LVM (β=11.8 [95% CI, 3.5-20.0]; P=0.005), LVM index (β=4.4 [95% CI, 0.5-8.3]; P=0.027), and carotid intima-media thickness (β=0.016 [95% CI, 0.002-0.030]; P=0.028) were higher in the low-CVH group. Conclusions CVH scores were suboptimal, declining with age. LE8 metrics indicated worse CVH in children with abnormal cardiovascular structural measurements, suggesting the validity of LE8 in assessing child CVH. Registration URL: https://www.chictr.org.cn/index.html; Unique identifier: ChiCTR2100044027.

Association of Cardiovascular Health Assessed by the New Life's Essential 8 Metrics With Years Lived Without Cardiovascular Disease.

Background The American Heart Association recently proposed an updated definition of cardiovascular health (CVH) named as Life's Essential 8. We aimed to explore the association between this latest published CVH measurement and years lived without cardiovascular disease (CVD) among the Chinese population. Methods and Results We included 89 755 adults free of CVD at baseline from the Kailuan study. The CVH of each participant was scored (from 0 point to 100 points) and classified (low [0-49 points], moderate [50-79 points], and high [80-100 points]) according to Life's Essential 8, which incorporated 8 components covering health behaviors and health factors. Incident CVD was documented through follow-ups from baseline (June 2006 to October 2007) until December 31, 2020. CVD-free life years from age 30 to 80 years associated with different CVH scores were estimated using flexible parametric survival models. A total of 9977 incident CVDs were recorded. We observed a gradient relationship between CVH score and years lived without CVD. The age- and sex-adjusted CVD-free life years (95% CI) were 40.7 (40.3-41.0) years for low CVH, 43.3 (43.0-43.5) years for moderate CVH, and 45.5 (45.1-45.9) years for high CVH. Similar trends were noted when individual subtypes of CVD were investigated, and high CVH evaluated by health behaviors and health factors was also related to longer CVD-free life years. Conclusions A higher CVH evaluated by the updated Life's Essential 8 metrics was significantly associated with a greater number of life years without CVD, indicating the importance of promoting CVH for healthy aging in China.

Application of Life's Essential 8 to assess cardiovascular health during early childhood.

Assess cardiovascular health (CVH) during early childhood using the American Heart Association's recently updated construct, Life's Essential 8 (LE8); examine concordance in CVH status per LE8 versusLife's Simple 7 (LS7); and identify perinatal correlates of high CVH per LE8. We applied LE8 and LS7 to data from 305 children aged 4-7 years in Denver, CO; estimated % low, moderate, high, and optimal CVH; assessed concordance in CVH status based on LE8 and LS7 using contingency tables; and used multivariable logistic regression to identify early-life correlates of high CVH per LE8. Average age of children was 4.7±0.6 years,44.6% were female. No participants had low or optimal CVH,43.9% had high, and 56.1% had moderate CVH per LE8, whereas 33.4% had high and 66.6% had moderate CVH per LS7. Twenty-two percent had high CVH based on both constructs. Correlates of high CVH were maternal prenatal diet quality (odds ratioHealthy Eating Index score>vs. ≤57 =1.90 [1.12, 3.21]) and child age (odds ratioper 1 year =1.58 [1.04. 2.42]). LE8 yielded higher prevalence of high CVH than LS7 during early childhood, though there is modest concordance between the two constructs. Maternal diet is a potential modifiable target to optimize early-life CVH.

Changes in Cardiovascular Health during Young Adulthood and Subclinical Atherosclerosis in Middle Age: The CARDIA Study.

The benefits of reaching ideal cardiovascular health (CVH) are well known, but it is unclear whether positive CVH changes from young adulthood to middle age reduce subclinical atherosclerosis risk. This study examined associations of changes in CVH from young adulthood to middle age and CVH in young adulthood with subclinical atherosclerosis. Data was analyzed from the Coronary Artery Risk Development in Young Adults (CARDIA) study. CVH was examined at years 0 and 20 using Life Simple 7 metrics from AHA guideline. Coronary artery calcium (CAC) was identified at years 20 and 25. Carotid intima-media thickness (IMT) was identified at year 20. Among 2,935 participants (56.2% women, 46.7% black), the change of CVH score was -1.26 (2.13). For per 1-unit increase in CVH at baseline, the adjusted odds ratios (ORs) of presence of CAC and IMT were 0.81 (95% CI 0.78, 0.86) and 0.85 (95% CI 0.76, 0.94), respectively. For per 1-unit increase in CVH changes, the adjusted ORs of CAC and IMT were 0.86 (95% CI 0.82, 0.90) and 0.81 (95% CI 0.73, 0.90). Compared with stable moderate CVH, improvement from moderate to high was associated with a lower risk of CAC (0.64 [95% CI 0.43, 0.96]), while retrogression from moderate to low was associated with a higher risk of CAC (1.45 [95% CI 1.19, 1.76]). Positive changes of CVH during young adulthood are associated with negative subclinical atherosclerosis risk in middle age, indicating the importance of reaching an ideal cardiovascular health status through young adulthood.