Association Between Life's Essential 8 Scores and Heart Failure: Insights From NHANES (2007-2020)

Area of Science:

• Cardiovascular Health
• Public Health
• Epidemiology

Background:

• Heart failure (HF) poses a significant public health challenge due to high morbidity, mortality, and economic costs.
• Early identification and prevention of modifiable risk factors are crucial for reducing HF prevalence.
• The American Heart Association's Life's Essential 8 (LE8) metrics provide a comprehensive cardiovascular health assessment framework.

Purpose of the Study:

• To investigate the association between LE8 metrics and HF prevalence in the American population.
• To determine if LE8 metrics can aid in HF risk stratification for public health initiatives.
• To explore the relationship between cardiovascular health as defined by LE8 and the occurrence of heart failure.

Main Methods:

• Cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data (2007-2020).
• Inclusion of participants aged ≥20 years with complete data on HF and LE8 metrics.
• Multiple logistic regression, subgroup analyses, interaction tests, smooth curve fitting, and ROC curve analysis were employed.

Main Results:

• A significant inverse dose-response relationship was observed between LE8 scores and HF prevalence.
• Individuals with the highest LE8 scores had a 70% lower prevalence of HF compared to those with the lowest scores (OR=0.30, P<0.01).
• Physical activity, nicotine exposure, sleep health, BMI, and plasma glucose were independently associated with HF prevalence.

Conclusions:

• Higher LE8 scores are strongly associated with a reduced prevalence of heart failure.
• The LE8 metrics show potential as a valuable tool for identifying at-risk populations for HF in public health settings.
• Improving cardiovascular health through LE8 components may be key to preventing heart failure.