0526 Life’s Essential 8 and the Risk of Cardiovascular Disease Among Individuals with and Without Obstructive Sleep Apnea Symptoms

Abstract Introduction The American Heart Association’s Life’s Essential 8 (LE8) is a composite measure of cardiovascular health. Obstructive sleep apnea (OSA) increases risk of cardiovascular disease (CVD), but less is known about differences by presence of OSA symptoms. We examined the association between LE8 scores and prevalent CVD and assessed effect modification by presence of OSA symptoms. Methods This cross-sectional study used data from 2015-2020 National Health and Nutrition Examination Survey (NHANES). We included adults aged≥18 years who self-reported OSA symptoms and excluded those pregnant or breastfeeding or had missing data on OSA or CVD measures. LE8 scores were computed using previously used algorithm (range 0-100) and categorized as low (0- 50), moderate (50- 80), and high (80-100) CVD health. OSA symptoms were defined as self-report of any three OSA symptoms: a) snoring ≥3 nights/week, b) snorting/stopping breathing ≥3 nights/week, or c) feeling overly sleepy during day 16-30 times/month. CVD was defined as self-reported physician diagnosis of angina, congestive heart failure, coronary artery disease, myocardial infarction, or stroke. We used multivariable logistic regression to estimate association between LE8 and CVD, overall and stratified by OSA symptoms, adjusting for age, gender, race, education level, marital status, poverty ratio, drinking status, and family history of CVD. Results Among 10,546 NHANES participants, 5,277 (48.5% weighted) reported any OSA symptom, and 5,269 (51.5%) did not. Higher LE8 scores were associated with lower odds of CVD, and results varied by OSA symptoms. Among participants with OSA symptoms, moderate and high LE8 scores were associated with significantly lower odds of CVD compared to those with low LE8 scores (moderate: adjusted odds ratio aOR=0.44; 95% confidence interval CI=0.32–0.59; high: aOR=0.17; 95% CI=0.07–0.39). In those without, associations were more modest (moderate: aOR=0.77, 95% CI=0.57–1.04; high: aOR=0.51, 95% CI=0.31–0.83). Conclusion Higher LE8 scores, reflecting better cardiovascular health, are associated with lower odds of prevalent CVD, particularly among adults reporting OSA symptoms. These results suggest optimizing cardiovascular health may be especially important in adults with OSA symptoms to reduce cardiovascular disease burden. Support (if any) National Institute on Aging (R01AG079391, K02AG095384, P30AG028740).