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March 27, 2023JMIR Public Health and SurveillanceOpen Access

Using the New “Life’s Essential 8” Metrics to Evaluate Trends in Cardiovascular Health Among US Adults From 2005 to 2018: Analysis of Serial Cross-sectional Studies

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Why the study?

The American Heart Association recently introduced the Life's Essential 8 (LE8) metrics to overcome limitations of Life's Simple 7, prompting an evaluation of secular trends in cardiovascular health among US adults from 2005 to 2018.

Population

21,667 US adults aged 20-79 years

Comparison

Trends across survey cycles from 2005-2006 to 2017-2018

Design

Serial cross-sectional study (NHANES)

Key result

The overall cardiovascular health score based on Life's Essential 8 metrics did not significantly change among US adults between 2005-2006 and 2017-2018.

Authors

CLCheng LiYLYanzhi LiMZMin Zhao

Discussion

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Overview

Stagnant US CVH scores signal need for intensified prevention; leaves open which interventions can reverse BMI and glucose trends.

Study Design

Type

Cross-Sectional (n=21,667)

Structured PICO

P
Population
21,667 US adults aged 20-79 years from the National Health and Nutrition Examination Survey (NHANES) between 2005-2006 and 2017-2018, excluding pregnant/breastfeeding women and individuals with self-reported CVD history.
O
Outcome
Age-standardized mean scores of overall cardiovascular health (CVH) and each of the Life's Essential 8 (LE8) components (diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, blood pressure) from 2005 to 2018.surrogate

Main Result

Absolute Event Rate: 65% vs 65.5%

p-value: p=0.82

Overall cardiovascular health among US adults did not significantly improve from 2005 to 2018 according to the Life's Essential 8 metrics, with worsening trends in BMI and blood glucose offsetting improvements in other areas.

Limitations

  • Based on data from 7 surveys over a rather short time period (<15 years)
  • Data on diet, physical activity, nicotine exposure, and sleep health were obtained by self-report, which may be inaccurate due to recall and social desirability biases
  • The 8 behavioral and health components are given equal weight in calculating the overall score
  • Other factors like familial history/genetics or comorbidities that can alter CVD risk were not included
  • Missing values on relevant variables, especially for dietary variables, might have affected the representativeness of the study population
  • Short time period (<15 years)
  • Self-reported data for diet, physical activity, nicotine exposure, and sleep health may be inaccurate due to recall and social desirability biases
  • The 8 behavioral and health components are given equal weight in calculating the LE8 overall CVH score
  • Other factors altering CVD risk (e.g., genetics, comorbidities) are not included
  • Missing values on relevant variables, especially dietary variables, might have affected representativeness

Cite This Study

Li et al. (2023) conducted a cross-sectional in Cardiovascular Health (n=21,667). Time period (2017-2018) vs. Time period (2005-2006) was evaluated on Age-standardized mean score of overall cardiovascular health (Life's Essential 8) (p=0.82). The overall cardiovascular health score based on Life's Essential 8 metrics did not significantly change among US adults between 2005-2006 and 2017-2018.

synapsesocial.com/papers/6a1789aa7afe20c06351e0c6https://doi.org/10.2196/45521
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