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Life's Essential 8 and carotid artery plaques : the Swedish cardiopulmonary bioimage study

Herraiz-Adillo, Ángel ; Ahlqvist, Viktor H. ; Higueras-Fresnillo, Sara ; Berglind, Daniel ; Wennberg, Patrik ; Lenander, Cecilia LU ; Daka, Bledar ; Ekstedt, Mattias ; Sundström, Johan and Ortega, Francisco B. , et al. (2023) In Frontiers in Cardiovascular Medicine 10.
Abstract

Background: To quantify cardiovascular health (CVH), the American Heart Association (AHA) recently launched an updated construct of the “Life's Simple 7” (LS7) score, the “Life's Essential 8” (LE8) score. This study aims to analyse the association between both CVH scores and carotid artery plaques and to compare the predictive capacity of such scores for carotid plaques. Methods: Randomly recruited participants aged 50–64 years from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analysed. According to the AHA definitions, two CVH scores were calculated: i) the LE8 score (0, worst CVH; 100, best CVH) and two different versions of the LS7 score [(0–7) and (0–14), 0 indicating the worst CVH]. Ultrasound-diagnosed carotid plaques... (More)

Background: To quantify cardiovascular health (CVH), the American Heart Association (AHA) recently launched an updated construct of the “Life's Simple 7” (LS7) score, the “Life's Essential 8” (LE8) score. This study aims to analyse the association between both CVH scores and carotid artery plaques and to compare the predictive capacity of such scores for carotid plaques. Methods: Randomly recruited participants aged 50–64 years from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analysed. According to the AHA definitions, two CVH scores were calculated: i) the LE8 score (0, worst CVH; 100, best CVH) and two different versions of the LS7 score [(0–7) and (0–14), 0 indicating the worst CVH]. Ultrasound-diagnosed carotid plaques were classified as no plaque, unilateral, and bilateral plaques. Associations were studied by adjusted multinomial logistic regression models and adjusted (marginal) prevalences, while comparison between LE8 and LS7 scores was performed through receiver operating characteristic (ROC) curves. Results: After exclusions, 28,870 participants remained for analysis (50.3% women). The odds for bilateral carotid plaques were almost five times higher in the lowest LE8 (<50 points) group [OR: 4.93, (95% CI: 4.19–5.79); adjusted prevalence 40.5%, (95% CI: 37.9–43.2)] compared to the highest LE8 (≥80 points) group [adjusted prevalence 17.2%, (95% CI: 16.2–18.1)]. Also, the odds for unilateral carotid plaques were more than two times higher in the lowest LE8 group [OR: 2.14, (95% CI: 1.82–2.51); adjusted prevalence 31.5%, (95% CI: 28.9–34.2)] compared to the highest LE8 group [adjusted prevalence 29.4%, (95% CI: 28.3–30.5)]. The areas under ROC curves were similar between LE8 and LS7 (0–14) scores: for bilateral carotid plaques, 0.622 (95% CI: 0.614–0.630) vs. 0.621 (95% CI: 0.613–0.628), P = 0.578, respectively; and for any carotid plaque, 0.602 (95% CI: 0.596–0.609) vs. 0.600 (95% CI: 0.593–0.607), P = 0.194, respectively. Conclusion: The new LE8 score showed inverse and dose-response associations with carotid plaques, particularly bilateral plaques. The LE8 did not outperform the conventional LS7 score, which showed similar ability to predict carotid plaques, especially when scored as 0–14 points. We conclude that both the LE8 and LS7 may be useful in clinical practice for monitoring CVH status in the adult population.

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publication status
published
subject
keywords
carotid atherosclerosis, Doppler ultrasound, health promotion, healthy lifestyle, population-based, SCAPIS project
in
Frontiers in Cardiovascular Medicine
volume
10
article number
1173550
publisher
Frontiers Media S. A.
external identifiers
  • pmid:37424911
  • scopus:85164530514
ISSN
2297-055X
DOI
10.3389/fcvm.2023.1173550
language
English
LU publication?
yes
id
94b85a9e-9352-4136-93cf-0fb10b2f32cd
date added to LUP
2023-09-27 11:18:08
date last changed
2024-04-19 01:43:03
@article{94b85a9e-9352-4136-93cf-0fb10b2f32cd,
  abstract     = {{<p>Background: To quantify cardiovascular health (CVH), the American Heart Association (AHA) recently launched an updated construct of the “Life's Simple 7” (LS7) score, the “Life's Essential 8” (LE8) score. This study aims to analyse the association between both CVH scores and carotid artery plaques and to compare the predictive capacity of such scores for carotid plaques. Methods: Randomly recruited participants aged 50–64 years from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analysed. According to the AHA definitions, two CVH scores were calculated: i) the LE8 score (0, worst CVH; 100, best CVH) and two different versions of the LS7 score [(0–7) and (0–14), 0 indicating the worst CVH]. Ultrasound-diagnosed carotid plaques were classified as no plaque, unilateral, and bilateral plaques. Associations were studied by adjusted multinomial logistic regression models and adjusted (marginal) prevalences, while comparison between LE8 and LS7 scores was performed through receiver operating characteristic (ROC) curves. Results: After exclusions, 28,870 participants remained for analysis (50.3% women). The odds for bilateral carotid plaques were almost five times higher in the lowest LE8 (&lt;50 points) group [OR: 4.93, (95% CI: 4.19–5.79); adjusted prevalence 40.5%, (95% CI: 37.9–43.2)] compared to the highest LE8 (≥80 points) group [adjusted prevalence 17.2%, (95% CI: 16.2–18.1)]. Also, the odds for unilateral carotid plaques were more than two times higher in the lowest LE8 group [OR: 2.14, (95% CI: 1.82–2.51); adjusted prevalence 31.5%, (95% CI: 28.9–34.2)] compared to the highest LE8 group [adjusted prevalence 29.4%, (95% CI: 28.3–30.5)]. The areas under ROC curves were similar between LE8 and LS7 (0–14) scores: for bilateral carotid plaques, 0.622 (95% CI: 0.614–0.630) vs. 0.621 (95% CI: 0.613–0.628), P = 0.578, respectively; and for any carotid plaque, 0.602 (95% CI: 0.596–0.609) vs. 0.600 (95% CI: 0.593–0.607), P = 0.194, respectively. Conclusion: The new LE8 score showed inverse and dose-response associations with carotid plaques, particularly bilateral plaques. The LE8 did not outperform the conventional LS7 score, which showed similar ability to predict carotid plaques, especially when scored as 0–14 points. We conclude that both the LE8 and LS7 may be useful in clinical practice for monitoring CVH status in the adult population.</p>}},
  author       = {{Herraiz-Adillo, Ángel and Ahlqvist, Viktor H. and Higueras-Fresnillo, Sara and Berglind, Daniel and Wennberg, Patrik and Lenander, Cecilia and Daka, Bledar and Ekstedt, Mattias and Sundström, Johan and Ortega, Francisco B. and Östgren, Carl Johan and Rådholm, Karin and Henriksson, Pontus}},
  issn         = {{2297-055X}},
  keywords     = {{carotid atherosclerosis; Doppler ultrasound; health promotion; healthy lifestyle; population-based; SCAPIS project}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Cardiovascular Medicine}},
  title        = {{Life's Essential 8 and carotid artery plaques : the Swedish cardiopulmonary bioimage study}},
  url          = {{http://dx.doi.org/10.3389/fcvm.2023.1173550}},
  doi          = {{10.3389/fcvm.2023.1173550}},
  volume       = {{10}},
  year         = {{2023}},
}