Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.).
Mayo Clinic College of Medicine, Rochester, MN (L.B.).
Circulation. 2022 Sep 13;146(11):822-835. doi: 10.1161/CIRCULATIONAHA.122.060911. Epub 2022 Jun 29.
The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score.
We included individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race and ethnicity, family income, and depression.
There were 23 409 participants, representing 201 728 000 adults and 74 435 000 children. The overall mean CVH score was 64.7 (95% CI, 63.9-65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2-68.7), and racial and ethnic group (range, 59.7-68.5). Mean scores were lowest for diet, physical activity, and body mass index metrics. There were large differences in mean scores across demographic groups for diet (range, 23.8-47.7), nicotine exposure (range, 63.1-85.0), blood glucose (range, 65.7-88.1), and blood pressure (range, 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1-88.3) and body mass index (range, 74.4-89.4) scores by sociodemographic group.
The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in individuals and the population.
美国心脏协会最近发布了更新的心血管健康量化算法——生命必需 8 要素评分。我们使用新评分来量化美国的心血管健康水平。
我们纳入了年龄在 2 至 79 岁之间（无心血管疾病，非孕妇或住院患者）的人群，这些人来自 2013 年至 2018 年的国家健康和营养检查调查。对于所有参与者，我们根据已发布的美国心脏协会定义，计算了整体心血管健康评分（范围为 0[最低]至 100[最高]），以及饮食、身体活动、尼古丁暴露、睡眠时间、体重指数、血脂、血糖和血压等各个组成部分的评分。使用标准调查程序，通过纳入样本权重和设计来计算患病率估计值和标准误差。在评估心血管健康评分时，我们考虑了年龄、性别、种族和民族、家庭收入以及抑郁等方面的分层情况。
共有 23409 名参与者，代表了 20172.8 万名成年人和 7443.5 万名儿童。在所有 8 项指标中，成年人的整体平均心血管健康评分为 64.7（95%置信区间，63.9-65.6），在 2 至 19 岁的儿童和青少年中，使用 3 项指标（饮食、身体活动和体重指数）时，评分为 65.5（95%置信区间，64.4-66.6）。对于成年人，整体心血管健康评分存在显著的性别差异（女性 67.0；男性 62.5）、年龄差异（平均值范围为 62.2-68.7）和种族和民族差异（范围为 59.7-68.5）。饮食、身体活动和体重指数指标的平均评分最低。在饮食（范围为 23.8-47.7）、尼古丁暴露（范围为 63.1-85.0）、血糖（范围为 65.7-88.1）和血压（范围为 49.5-84.0）方面，不同人群的平均评分存在显著差异。在儿童中，饮食评分较低（平均 40.6），且随着年龄的增长而逐渐降低（从 2 至 5 岁时的 61.1 分降至 12 至 19 岁时的 28.5 分）；社会人口学群体之间的身体活动（范围为 63.1-88.3）和体重指数（范围为 74.4-89.4）评分也存在较大差异。
新的生命必需 8 要素评分有助于识别心血管健康的群体和个体差异。美国人口的整体心血管健康状况仍远低于理想水平，在个体和人群的整个生命周期中，都存在广泛的和有针对性的机会来监测、保护和改善心血管健康。
