Association between Life’s Essential 8 and abdominal aortic calcification: findings from a national study

Background and aims Data are lacking regarding Life’s Essential 8 (LE8), a cardiovascular health (CVH) scoring system recently updated by the American Heart Association, and abdominal aortic calcification (AAC). We aimed to detect the associations of total and individual CVH metrics based on LE8 with AAC-score and AAC prevalence. Methods We conducted a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2013–2014. Individuals with a score exceeding 0 or 6 were considered as having AAC and severe AAC, respectively. Total and individual CVH metric scores were stratified into low level (0–49), intermediate level (50–74), and high level (75–100). Multivariable linear or logistic regression models were performed to calculate β or odds ratios (ORs) and corresponding 95% confidence interval (CI) for the associations of total and individual CVH metrics with AAC. For further exploration, restricted cubic spline curves and subgroup analyses were performed. Results 2,403 eligible participants were finally included. Compared to those with a low total CVH score, adults with a high total CVH score were associated with lower AAC-score [β: -0.50, (-0.95, -0.06), P  = 0.0277] and reduced prevalence of AAC (OR: 0.57, (0.41, 0.80), P  = 0.0013] and severe AAC [OR: 0.52, (0.30, 0.90), P  = 0.0197]. There was a nonlinear and linear dose–response inverse associations of total CVH score with AAC and severe AAC, respectively. For the eight individual CVH metrics, well management of nicotine exposure, blood glucose and blood pressure was the major individual contributor to prevent AAC. Equally, enough engagement of physical activity could partly reduce AAC risk. Conclusions The ideal CVH assessed by Life’s Essential 8 metrics was significantly associated with reduced AAC risk. We emphasize that earlier efforts on promoting CVH metrics should be highlighted to reduce AAC prevalence and subsequent CVD in later life.