Relations of Life's Essential 8 score with arterial and microvascular function: The Jackson Heart Study

The American Heart Association (AHA) Life's Essential 8 (LE8) provides a means of scoring cardiovascular health but has yet to be correlated with vascular function in an African American cohort.

In a sample of Jackson Heart Study participants (N = 2186, mean age 57 years, 65% women), LE8 scores were calculated per AHA guidelines at baseline visits (2000-2004). Noninvasive vascular assessments were performed within an ancillary study (2012-2017). Tests included carotid-femoral pulse wave velocity, carotid-brachial pulse wave velocity, carotid-radial pulse wave velocity, central pulse pressure, forward pressure wave, and characteristic impedance, as well as brachial artery baseline and hyperemic flow velocities. Linear regression models, adjusted for age, age squared, sex, and heart rate, assessed the associations of LE8 composite and component scores with vascular function.

A higher LE8 score was associated with lower carotid-femoral pulse wave velocity (β = -0.32; 95% CI: -0.42, -0.21; p < 0.0001), characteristic impedance (β = -0.57; 95% CI: -0.93, -0.20; p = 0.0024), forward pressure wave amplitude (β = -0.21; 95% CI: -0.26, -0.16; p < 0.0001), central pulse pressure (β = -0.25; 95% CI: -0.32, -0.19; p < 0.0001), and brachial baseline flow velocity (β = -0.013; 95% CI: -0.023, -0.002; p = 0.021). Higher LE8 scores were associated with higher brachial hyperemic flow velocity (β = 0.095; 95% CI: 0.035, 0.15; p = 0.0018). Blood glucose and blood pressure were the components most significantly associated with vascular function.

Our findings support the concept that a healthy lifestyle is predictive of better vascular function. Future longitudinal studies are warranted to investigate whether improving LE8 scores leads to improved vascular function.