Li Jiangtao, Wei Xiang
Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China.
Am J Prev Cardiol. 2025 Aug 7;23:101071. doi: 10.1016/j.ajpc.2025.101071. eCollection 2025 Sep.
BACKGROUND: The American Heart Association has recently updated its definition of what constitutes cardiovascular health (CVH), known as Life's Essential 8 (LE8). This study evaluated the current status of CVH in US adults using the LE8 score and compared the overall CVH and each CVH metric between the pre-COVID-19 era and the COVID-19 era. METHODS: Participants aged 20 to 79 years without a history of cardiovascular disease in the National Health and Nutrition Examination Survey (NHANES) cycles from 2017 to 2023 were included. The LE8 score and its components were analyzed in the entire population and further categorized by gender, age, race/ethnicity, education, household poverty, and depression. CVH scores were also assessed between the pre-COVID-19 era and the COVID-19 era. Sample weights and design were incorporated to calculate prevalence estimates and standard errors using standard survey procedures. RESULTS: Among 11,939 adults, representing approximately 207,742,565 US adults, the mean overall CVH score was 68.5 (95 % CI, 67.6-69.4). Significant differences in mean overall CVH scores were observed by gender (women: 69.8; men: 67.2) and age groups (20-44 years: 72.1; 45-64 years: 65.5; 65-79 years: 65.2). Overall CVH scores were highest among non-Hispanic (NH) Asian (75.2) individuals, followed by NH White (69.0), other Hispanic (68.4), Mexican (67.6), and NH Black (64.6). Diet, physical activity, and body mass index had the lowest mean scores, while sleep health and blood glucose had the highest. Substantial differences in mean scores across demographic groups were observed for body mass index (range, 49.4-78.5), blood glucose (range, 73.4-92.4), and blood pressure (range, 55.4-82.2). Overall mean CVH scores significantly improved during the COVID-19 era (70.2 vs. 68.9) compared to the pre-COVID-19 era, primarily driven by increased scores on physical activity (72.8 vs. 52.4) and nicotine exposure (74.4 vs. 70.2). The prevalence of high CVH was significantly higher during the COVID-19 era compared to the pre-COVID-19 era (26.7 % vs. 22.2 %), while the prevalence of low CVH was decreased (7.6 % vs. 13.6 %). CONCLUSION: Despite improvements during the COVID-19 era, overall CVH among US adults remains suboptimal. Future research should prioritize interventions aimed at enhancing the CVH of the US population.
背景：美国心脏协会最近更新了心血管健康（CVH）的定义，即“生命的八大要素”（LE8）。本研究使用LE8评分评估了美国成年人的心血管健康现状，并比较了新冠疫情前时代和新冠疫情时代的总体心血管健康及各项心血管健康指标。 方法：纳入了2017年至2023年国家健康与营养检查调查（NHANES）周期中年龄在20至79岁且无心血管疾病史的参与者。在整个人口中分析了LE8评分及其组成部分，并按性别、年龄、种族/族裔、教育程度、家庭贫困状况和抑郁情况进一步分类。还评估了新冠疫情前时代和新冠疫情时代的心血管健康评分。采用标准调查程序纳入样本权重和设计，以计算患病率估计值和标准误差。 结果：在11939名成年人中，约代表2.07742565亿美国成年人，总体心血管健康评分的平均值为68.5（95%CI，67.6 - 69.4）。按性别（女性：69.8；男性：67.2）和年龄组（20 - 44岁：72.1；45 - 64岁：65.5；65 - 79岁：65.2）观察到总体心血管健康评分平均值存在显著差异。总体心血管健康评分在非西班牙裔（NH）亚洲人（75.2）中最高，其次是NH白人（69.0）、其他西班牙裔（68.4）、墨西哥人（67.6）和NH黑人（64.6）。饮食、身体活动和体重指数的平均得分最低，而睡眠健康和血糖的得分最高。在体重指数（范围49.4 - 78.5）、血糖（范围73.4 - 92.4）和血压（范围55.4 - 82.2）方面，不同人口统计学组的平均得分存在显著差异。与新冠疫情前时代相比，新冠疫情时代总体心血管健康评分平均值显著提高（70.2对68.9），主要是由于身体活动得分增加（72.8对52.4）和尼古丁暴露得分增加（74.4对70.2）。与新冠疫情前时代相比，新冠疫情时代高心血管健康的患病率显著更高（26.7%对22.2%），而低心血管健康的患病率有所下降（7.6%对13.6%）。 结论：尽管在新冠疫情时代有所改善，但美国成年人的总体心血管健康仍不理想。未来的研究应优先考虑旨在提高美国人群心血管健康的干预措施。
J Am Heart Assoc. 2023-12-5
JMIR Public Health Surveill. 2023-3-31
Am J Prev Cardiol. 2022-12-23
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