Trends in cardiovascular health based on Life's Essential 8 among Korean adults, 2007-2023

In 2022, the American Heart Association introduced Life's Essential 8 (LE8), an updated framework for assessing cardiovascular health (CVH). This study examined trends in overall LE8 CVH and individual metric scores from 2007 to 2023 in the Korean adult population.

We conducted a serial, cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (KNHANES; waves 4-9), adults aged ≥20 years. CVH was assessed using LE8 metrics, each scored range of 0-100. The overall score was calculated as the mean of the eight metrics and categorized as low (0-<50), moderate (50-<80), or high (80-100).

There were 76,255 participants, representing 35,494,751 adults. The mean (95% CI) CVH score declined from 68.5 (68.1-68.9) in 2007-2009 to 65.9 (65.5-66.2) in 2016-2018, and returned to 68.5 (68.1-69.0) in 2022-2023. In the most recent period, women had higher mean scores than men (72.8 [95% CI: 72.2-73.3] vs. 64.3 [95% CI: 63.7-64.8]), and adults aged 20-39 years scored higher than those aged ≥70 years (72.5 [95% CI: 72.0-73.1] vs. 64.5 [95% CI: 63.9-65.1]). Trends varied by individual metrics. Sleep health and blood glucose scores remained high. Nicotine exposure, body mass index, blood lipids, and blood pressure scores remained moderate. Diet and physical activity scores remained low. These patterns also differed by sex and age.

Over the 17 years, CVH in Korean adults remained in the moderate range, with a decline through 2018 and full recovery by 2022-2023. Differences by age and sex underscore the need for tailored prevention strategies.