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Brain & Heart The relationship between LE8 score and ASCVD

(2.8%). This condition is expected to contribute to a rising sampling design, the survey aims to capture a diverse and
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number of ASCVD-related deaths, reaching 20 million comprehensive view of the population’s health. The survey
worldwide by 2030. Over the previous century, ASCVD systematically gathers self-reported and directly measured
has consistently been identified as a significant contributor data from participants, including health conditions,
to mortality rates in the USA. Given the generally low behaviors, dietary intake, physical examination, and
heritability of cardiovascular health (CVH) traits, the laboratory tests. A comprehensive description of NHANES
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role of behavioral and environmental factors as ASCVD has been previously published. 6
risk factors is crucial. Emphasis on improvements of
behavioral measures and health factors from a young age 2.2. Study population
becomes critical for preserving ideal CVH into middle age Adults aged 20 and above, identified as NH white, both with
and minimizing ASCVD. Therefore, the American Heart and without ASCVD, and participating in the NHANES
Association (AHA) has instituted a set of CVH metrics conducted from 2017 to 2020 were considered. The final
to improve the CVH on both individual and population sample of 5042 participants was derived from various
scales, which should be assessed and tracked across groups. datasets using essential variables, including questionnaires,
Recognizing the importance of a multifactorial approach dietary, and demographic data.
in the prevention of CVD, the AHA introduced an updated
set of metrics in 2022, known as Life’s Essential 8 (LE8). ASCVD was determined through participant self-
These metrics are designed to guide and enhance the report, as individuals were asked to respond to inquiries
efforts to reduce the prevalence of ASCVD in the overall such as, “Have you ever received confirmation from a
popuation. 3 medical professional indicating the presence of stroke,
angina, myocardial infarction, or CHD?” The designation
Prior investigations have revealed elevated stroke of having ASCVD was attributed to participants providing
mortality rates within the African American population an affirmative response to any of the specified conditions.
compared to whites, attributable to an increased incidence This extensively utilized criterion has been previously
of comorbidities, such as hypertension, diabetes mellitus, recorded in the literature. 7-10
and obesity. These findings, particularly those from
cohorts of individuals free of prevalent cardiovascular 2.3. Assessment of LE8
disease at baseline, with over a 26-year temporal span, align In 2022, the AHA unveiled a new framework for measuring
with analogous conclusions posited by other scholars. health, known as LE8, which builds on and extends the
4,5
Concurrently, the prevalence of individuals attaining concepts introduced in Life’s Simple 7 (LS7). The LE8
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optimal CVH scores among whites marginally fell below framework employs a more intricate algorithm for the
40%, while the corresponding rates for Mexican and black quantification of each metric and incorporates sleep health
Americans markedly registered at 25%. 5 as an additional parameter (Table S1). The LE8 includes
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While previous work mostly addressed individuals eight components: four behavioral health measures (diet,
free of CVD, scant attention has been given to assessing sleep health, physical activity, and exposure to nicotine),
the association of CVH metrics in adults with ASCVD, and four health factors (normalized plasma glucose levels,
which includes stroke and CHD, the primary contributors body mass index [BMI], blood lipids, and blood pressure).
to global cardiovascular mortality. By utilizing nationally The LE8 scores were conceived on a continuous scale
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representative data from 2017 to 2020, this research seeks from 0 to 100, which increased the sensitivity of the metrics.
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to examine the existing relationship between the AHA’s Consequently, in this study, individual LE8 metrics were
LE8 scores and the prevalence of ASCVD among non- computed as the mean of its eight constituent components,
Hispanic (NH) white individuals in the USA.
each graded on a scale from 0 to 100. Scores falling within
2. Methods the ranges of ≤49, 50 – 79, and ≥80 were, respectively,
classified as indicative of poor, intermediate, or ideal CVH.
2.1. Study design
This research utilized aggregated cross-sectional, 2.3.1. Health behavior assessment
secondary data from the National Health and Nutrition Standardized questionnaires administered during study
Examination Survey (NHANES), conducted between 2017 visits assessed the participants’ self-reported health
and 2020. The NHANES study is derived from a nationally behaviors. The evaluation of dietary intake utilized the
representative survey administered every 2 years, covering Automated Self-Administered 24-h (ASA24) Dietary
the nonmilitary, non-institutionalized United States (US) Assessment Tool, where participants reported their food
population. Employing a complex multistage-probability consumption exclusively for the preceding 24-h period,

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