Research on Cardiovascular Health and Longevity Focuses on AHA Life’s Essential 8 (LE8) Components

April 18, 2023 — Researchers who studied the impact of adherence to key health metrics on longevity have published findings that reinforce the value of lifestyle behaviors and health factors. The study, “Cardiovascular Health and Life Expectancy Among Adults in the United States,” was published April 10 in the American Heart Association (AHA) journal Circulation.

Highlighting the American Heart Association updated algorithm for evaluating cardiovascular health (CVH) — AHA's Life’s Essential 8 (LE8) score, researchers aimed to quantify the associations of CVH levels, estimated by the LE8 score, with life expectancy in a nationally representative sample of US adults.

Results led authors to conclude that adhering to a high CVH, defined as the LE8 score, is related to a considerably increased life expectancy in US adults. Their research found that people with higher scores for cardiovascular health lived up to nine years longer on average than those with the lowest scores. 

Updated by the American Heart Association in June, 2022, “Life’s Essential 8” includes the eight components of cardiovascular health: healthy diet, participation in physical activity, avoidance of nicotine, healthy sleep, healthy weight, and healthy levels of blood lipids, blood glucose, and blood pressure.

The study was conducted by a group of researchers led by Hao Ma, PhD, and Xuan Wang, PhD, both from the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, who contributed equally. They were joined by the following departmental colleagues: Qiaochu Xue, Xiang Li, Yoriko Helanza, and Lu Qi, along with: Zhaoxia Liang, Obstetrical Department, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China; and Oscar H. Franco, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands.

Researchers included 23,003 non-pregnant, non-institutionalized participants aged 20 to 79 years who participated in the National Health and Nutrition Examination Survey from 2005 to 2018, and whose mortality was identified through linkage to the National Death Index through December 31, 2019. The overall CVH was evaluated by the LE8 score (range, 0–100), as well as the score for each component of diet, physical activity, tobacco/nicotine exposure, sleep duration, body mass index, non–high-density lipoprotein cholesterol, blood glucose, and blood pressure. Life table method was used to estimate life expectancy by levels of the CVH.

Findings were reported as follows: during a median of 7.8 years of follow-up, 1359 total deaths occurred. The estimated life expectancy at age 50 years was 27.3 years (95% CI, 26.1–28.4), 32.9 years (95% CI, 32.3–33.4), and 36.2 years (95% CI, 34.2–38.2) in participants with low (LE8 score <50), moderate (50≤ LE8 score <80), and high (LE8 score ≥80) CVH, respectively. Equivalently, participants with high CVH had an average 8.9 (95% CI, 6.2–11.5) more years of life expectancy at age 50 years compared with those with low CVH. On average, 42.6% of the gained life expectancy at age 50 years from adhering to high CVH was attributable to reduced cardiovascular disease death.

As reported in an AHA news summary of the published report: The new findings provide evidence "that you can modify your lifestyle to live longer," according to lead study author Dr. Lu Qi, a professor of epidemiology and director of the Tulane University Obesity Research Center in New Orleans. The summary offered additional findings:

Using a 100-point scale, the researchers determined whether participants had low (scoring under 50), moderate (50 to 79) or high (80 or higher) cardiovascular health scores for each of the eight components. They also calculated an overall cardiovascular health score.

Findings also included:

• People with the highest overall scores had an average 8.9 more years of life expectancy at age 50 than those with the lowest scores.
• Among the individual components, tobacco use, sleep, physical activity and blood glucose levels had the greatest impact on life expectancy.
• Compared to people who smoked the most, those who did not smoke lived 7.4 years longer.
• Those who slept the recommended seven to nine hours per night lived five years longer than those who slept too much or not enough.
• People who were most physically active lived 4.6 years longer than those who were least active. And those who scored higher for maintaining control of blood glucose lived 4.9 years longer than those with poor blood glucose control.
• About 42% of the gain in life expectancy was attributable to fewer cardiovascular-related deaths.

Similarly significant associations of CVH with life expectancy were observed in men and women, respectively. Similarly significant associations of CVH with life expectancy were observed in White participants and Black participants but not in Mexican participants. The authors noted that more research needs to be done in other races and ethnicities (eg, Hispanic and Asian).

For more information: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062457

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