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 Through 2018

Author:

Lloyd-Jones Donald M.1ORCID,Ning Hongyan1,Labarthe Darwin1,Brewer LaPrincess2ORCID,Sharma Garima3ORCID,Rosamond Wayne4ORCID,Foraker Randi E.5ORCID,Black Terrie6,Grandner Michael A.7,Allen Norrina B.1,Anderson Cheryl8ORCID,Lavretsky Helen9,Perak Amanda M.1

Affiliation:

1. Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.).

2. Mayo Clinic College of Medicine, Rochester, MN (L.B.).

3. Johns Hopkins University School of Medicine, Baltimore, MD (G.S.).

4. University of North Carolina Gillings School of Public Health, Chapel Hill (W.R.).

5. Washington University School of Medicine, St Louis, MO (R.E.F.).

6. University of Massachusetts Amherst College of Nursing (T.B.).

7. University of Arizona College of Medicine, Tucson (M.A.G.).

8. The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla (C.A.).

9. University of California Los Angeles (H.L.).

Abstract

Background: The American Heart Association 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 individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association 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 and 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% CI, 63.9–65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4–66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2–68.7), and racial and ethnic group (range, 59.7–68.5). Mean scores were lowest for diet, physical activity, and body mass index 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 blood pressure (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 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1–88.3) and body mass index (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 individuals and the population.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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