Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates from the National Health and Nutrition Examination Survey (NHANES), 2013-2018

Donald M Lloyd-Jones, Hongyan Ning, Darwin Labarthe, LaPrincess Brewer, Garima Sharma, Wayne Rosamond, Randi E Foraker, Terrie Black, Michael A Grandner, Norrina B Allen, Cheryl Anderson, Helen Lavretsky (+1 others)
The American Heart Association (AHA) recently published an updated algorithm for quantifying cardiovascular health (CVH)-the "Life's Essential 8™" score. We quantified US levels of CVH using the new score. Methods: We included non-pregnant, non-institutionalized individuals ages 2 through 79 years who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013-2018. For all participants, we calculated the overall CVH score (range 0 [lowest] to 100
more » ... est]), as well as the score for each component of diet, physical activity (PA), nicotine exposure, sleep duration, body mass index (BMI), blood lipids, blood glucose, and blood pressure (BP), using published AHA definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race/ethnicity, family income, and depression. Results There were 23,409 participants, representing 201,728,000 adults and 74,435,000 children. The overall mean CVH score was 64.7 (95% confidence interval [CI], 63.9-65.6) among adults using all 8 metrics, and it was 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, PA, and BMI) among children/adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women: 67.0 vs. men: 62.5), age (range of mean values 62.2-68.7), and racial/ethnic group (range 59.7-68.5). Mean scores were lowest for diet, PA, and BMI metrics. There were large differences in mean scores across demographic groups for diet (range 23.8-47.7), nicotine exposure (range 63.1-85.0), blood glucose (range 65.7-88.1) and BP (range 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2-5 to 28.5 at ages 12-19); large differences were also noted in mean PA (range 63.1-88.3) and BMI (range 74.4-89.4) scores by sociodemographic group. Conclusions: The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels, and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in both individuals and the population.
doi:10.1161/circulationaha.122.060911 pmid:35766033 fatcat:w6z2y5bwfneg5aqjru44fh546u