Association between life's essential 8 and epilepsy: A cross-sectional study (NHANES 2013-2018)

Epilepsy, a prevalent chronic neurological disorder, has significant neurobiological, cognitive, psychological, and social implications. The American Heart Association (AHA) introduced Life's Essential 8 as a key metric for assessing cardiovascular health. This study aims to investigate the association between Life's Essential 8 and epilepsy prevalence, offering population-level evidence on the potential clinical and public health relevance of cardiovascular health in individuals with epilepsy. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2013 to 2018. A cross-sectional design was used, and logistic regression models, subgroup analyses were utilized to assess the association between LE8 and the prevalence of epilepsy. Restricted cubic splines were utilized to examine the nonlinear correlations. A total of 9408 participants were included in the study. After adjusting for potential confounding factors, LE8 showed a significant inverse association with the odds of epilepsy (odds ratio = 0.98, 95% confidence interval [CI]: 0.96-0.99). Restricted cubic spline analysis revealed a linear relationship between LE8 and the odds of epilepsy (P for nonlinearity = .658). Further analysis indicated that the diet score was significantly inversely associated with the odds of epilepsy (odds ratio  = 0.99, 95% CI: 0.98-0.99). Subgroup analysis showed no significant interaction between confounding factors and LE8 on the odds of epilepsy (all interaction P values > .05). Higher LE8 scores were independently associated with lower odds of epilepsy. Despite the modest effect size, these findings suggest potential clinical and public health implications, highlighting the importance of promoting cardiovascular health behaviors, particularly dietary improvements, in relation to epilepsy prevalence.