Life's Essential 8 and Suicide Risk: A Population-Level Study of Cardiovascular Health as a Mental Health Indicator

Cardiovascular health (CVH), assessed through Life's Essential 8 (LE8), has been widely studied in relation to physical health outcomes. However, its association with mental health, including psychological distress, suicidal behavior, and mental health service utilization, remains underexplored. This study examined whether better CVH is associated with reduced risk of mental health problems and greater engagement with mental health services.

We conducted a cross-sectional analysis using data from 4,106 Korean adults aged ≥19 years from the 2021 Korea National Health and Nutrition Examination Survey. CVH was measured using LE8 and categorized into low (0-49), moderate (50-79), and high (80-100) groups. Mental health outcomes included perceived stress, depressive mood, suicidal ideation, suicide planning, suicide attempts, and mental health service utilization.

Higher LE8 scores were significantly associated with lower stress (p=0.041) and reduced odds of suicidal ideation (p=0.001). Compared to the low CVH group, adjusted odds ratios (ORs) for stress perception were 0.748 (95% confidence interval [CI]: 0.587-0.953) in the moderate group and 0.685 (95% CI: 0.491-0.956) in the high group. For suicidal ideation, the ORs were 0.517 (95% CI: 0.329-0.813) and 0.199 (95% CI: 0.078-0.507), respectively. LE8 health behaviors, not health factors, were significantly associated with stress perception and suicidal ideation.

Better CVH is associated with lower psychological distress and suicidal behavior, with health behaviors in LE8 showing stronger associations with mental health outcomes than health factors. Further longitudinal studies are needed to confirm causality and underlying mechanisms.