Examining the relationship between Life’s Essential 8 and atherosclerotic cardiovascular disease among Adults in the United States: Insights from the National Health and Nutrition Examination Surveys (2017-2020)

The American Heart Association recently updated the assessment of cardiovascular health (CVH) with the Lifes Essential 8 (LE8) score. Our cross-sectional analytical study utilized data from 5042 adults in the United States (US) from the 2017 to 2020 NHANES surveys to examine the relationship between CVH assessed by LE8 metrics and the prevalence of atherosclerotic cardiovascular disease (ASCVD). Multivariate linear regressions were utilized to explore the relationship between CVH metrics and ASCVD, while linear probability models were used to predict ASCVD prevalence based on achieved LE8 scores. Controlling for relevant covariates revealed an inverse association between LE8 metrics and ASCVD prevalence. Improvements in LE8 were linked to a 29% reduction in ASCVD prevalence, with transitions to higher LE8 quartiles predicting a 4.8% reduction in ASCVD prevalence. Subgroup analysis indicated significant effects of age, education, and gender on ASCVD prevalence, with younger age, college education, and the female gender being associated with lower prevalence (P < 0.05). Higher LE8 scores correlated with decreased ASCVD prevalence, while factors such as younger age, college education, and the female gender were also associated with lower ASCVD prevalence. Conversely, transitioning from married to divorced/widowed/separated status was linked to increased ASCVD prevalence (P < 0.01).