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Brain & Heart

ORIGINAL RESEARCH ARTICLE
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)

1
Abraham M. Enyeji * and David L. Wetzell 2
1 Division of Community Medicine, Mercer University School of Medicine, Columbus Georgia, United
States of America
2 Division of Economics, Michigan State University, East Lansing, Michigan, United States of America

Abstract

The American Heart Association recently updated the assessment of cardiovascular
health (CVH) with the Life’s 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
*Corresponding author: linear regressions were utilized to explore the relationship between CVH metrics
Abraham M. Enyeji and ASCVD, while linear probability models were used to predict ASCVD prevalence
(enyeji_a@mercer.edu) based on achieved LE8 scores. Controlling for relevant covariates revealed an
Citation: Enyeji AM, Wetzell DL. inverse association between LE8 metrics and ASCVD prevalence. Improvements in
Examining the relationship LE8 were linked to a 29% reduction in ASCVD prevalence, with transitions to higher
between Life’s Essential 8 and LE8 quartiles predicting a 4.8% reduction in ASCVD prevalence. Subgroup analysis
atherosclerotic cardiovascular
disease among Adults in the United indicated significant effects of age, education, and gender on ASCVD prevalence,
States: Insights from the National with younger age, college education, and the female gender being associated with
Health and Nutrition Examination lower prevalence (P < 0.05). Higher LE8 scores correlated with decreased ASCVD
Surveys (2017-2020). Brain &
Heart. 2024;2(2):2915. prevalence, while factors such as younger age, college education, and the female
doi: 10.36922/bh.2915 gender were also associated with lower ASCVD prevalence. Conversely, transitioning
Received: February 12, 2024 from married to divorced/widowed/separated status was linked to increased ASCVD
prevalence (P < 0.01).
Accepted: April 9, 2024
Published Online: May 14, 2024
Keywords: Cardiovascular disease; Cardiovascular health; Non-Hispanic; Life’s Simple 8;
Copyright: © 2024 Author(s). Healthy Eating Index
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Atherosclerotic cardiovascular disease (ASCVD) continues to pose a significant burden,
Publisher’s Note: AccScience both in the United States of America (USA) and globally. In 2020 in the USA, coronary
Publishing remains neutral with heart disease (CHD) deaths constituted the most prevalent cause of cardiovascular
regard to jurisdictional claims in
published maps and institutional deaths (41.3%), followed by stroke (17.2%), other cardiovascular diseases (CVDs)
affiliations. (17.3%), hypertension (11.7%), cardiac insufficiency (9.9%), and artery diseases

Volume 2 Issue 2 (2024) 1 doi: 10.36922/bh.2915