Associations between life's essential 8 and the risk of cardiovascular disease in national US population: evidence from NHANES 2005–2018

Background: Cardiovascular health (CVH) is closely linked to cardiovascular disease (CVD)-specific mortality, yet research on Life's Essential 8 (LE8), a new CVH indicator, and its association with CVD risk is limited. Objective: This study aims to explore the association between LE8 and CVD risk in US adults. Methods: A total of 22,298 participants were included in this cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. LE8 scores were categorized into low, moderate, and high groups. Multivariate logistic regression and restricted cubic spline (RCS) models were employed to examine the association between LE8 scores and CVD risk. Results: In the multivariate-adjusted model, individuals with moderate and high LE8 scores exhibited a 53% (odds ratio OR = 0.47, 95% confidence interval CI: 0.41-0.54) and 77% (OR = 0.23, 95% CI: 0.18-0.30) reduction in total CVD risk compared to those with low LE8 scores. RCS analyses revealed an inverse dose-response relationship between LE8 scores and total CVD risk. A consistently negative association was observed between LE8 scores and the risk of CVD subtypes, including congestive heart failure, coronary heart disease, angina pectoris, heart attack, and stroke. Subgroup analyses indicated a more pronounced inverse association between LE8 scores and total CVD risk among participants under 50 years old and with a family history of CVD. Conclusions: These findings suggest a strong inverse relationship between LE8 and CVD risk. Improving CVH through adherence to LE8 guidelines has significant potential to reduce the burden of CVD.