Life's Essential 8 cardiovascular health status of 18–69-year-old individuals in France

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-03-30 DOI:10.1016/j.ajpc.2025.100981

Omar Deraz , Sofiane Kab , Mathilde Touvier , Xavier Jouven , Marcel Goldberg , Marie Zins , Jean-Philippe Empana

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Abstract

Background

In 2022, the previously American Heart Association (AHA) life's simple 7 score (range 0 to 14) measuring cardiovascular health (CVH) has been updated by adding sleep health and providing more granularity to the score (range 0 to 100) to measure the so-called Life's Essential 8 (LE8) score. However, the distribution of the LE8 score in nationwide representative US and non-US populations is scarce. The present study quantifies LE8 score distribution and identifies determinants of high CVH (80–100 points) in French adults.

Methods

CONSTANCES is a nationwide French cohort study that randomly recruited participants aged 18 to 69 years in 24 participating health examination centers in 21 French “départements” in different regions of France between 2012 and 2019. Design weights for age class, sex, socio economic status, and examination center/region were applied to represent the source population. LE8 score was quantified using inclusion data on eight CVH metrics. The prevalence estimates were age-standardized directly using the 2022 EU 28 population. Mixed effects multivariable linear and logistic regression models identified key LE8 score determinants.

Results

The study included 191,335 participants free of prior cardiovascular disease, with an average age of 46.48 years (SD 13.41) and 54 % women, representing 45.17 million individuals aged 18–69 in France. The overall mean LE8 score was 66.11 (68.92 in women vs. 62.79 in men, p = 6.875e⁻⁷), 13.21 %, 76.81 %, and 9.43 % achieved high (≥ 80 points), moderate (50–79 points), and poor (< 50 points) LE8 levels, respectively. Diet had the lowest mean score (41.50), while blood glycemia had the highest mean score (95.50). Mixed effects multivariable regression models identified younger age, womanhood, high educational attainment, self-employment, or managerial positions, not living with a partner, fewer depressive symptoms, lower alcohol consumption, rural residence, less socioeconomic deprivation, and absence of CVD family history as predictors of higher LE8 scores.

Conclusions

Only 13.21 % of adults in France achieved a high LE8 score (≥ 80 points), and disparities related to individual and contextual socio-demographic factors and mental health were identified. The findings further underscore the importance of timely implementation of effective and personalized primordial prevention strategies.

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18 - 69岁法国人的基本心血管健康状况

在2022年，之前的美国心脏协会（AHA）生活简单7分（范围0到14）衡量心血管健康（CVH）已经更新，增加了睡眠健康，并提供了更多的粒度得分（范围0到100）来衡量所谓的生活基本8分（LE8）得分。然而，LE8分数在全国范围内具有代表性的美国和非美国人口中的分布很少。本研究量化了LE8评分分布，并确定了法国成年人高CVH（80-100分）的决定因素。constance是一项全国性的法国队列研究，在2012年至2019年期间，在法国不同地区的21个法国“daca”的24个参与健康检查中心随机招募年龄在18至69岁之间的参与者。采用年龄阶层、性别、社会经济地位和考试中心/地区的设计权值来代表源人群。LE8评分采用8个CVH指标的纳入数据进行量化。患病率估计是直接使用2022年欧盟28国人口进行年龄标准化的。混合效应多变量线性和逻辑回归模型确定了关键的LE8分数决定因素。该研究包括191335名无心血管疾病的参与者，平均年龄46.48岁（SD 13.41）， 54%为女性，代表法国年龄在18-69岁的4517万人。总体平均LE8评分为66.11（女性为68.92，男性为62.79,p = 6.875e−7），高（≥80分）、中（50 ~ 79分）、差(<；50分)，LE8级。饮食平均得分最低（41.50），血糖平均得分最高（95.50）。混合效应多变量回归模型发现，年龄较小、女性、受教育程度高、自营职业或管理职位、未与伴侣同住、抑郁症状较少、酒精摄入量较低、居住在农村、社会经济剥夺较少、无心血管疾病家族史是LE8得分较高的预测因素。结论法国只有13.21%的成年人获得LE8高分（≥80分），存在与个体和环境社会人口因素以及心理健康相关的差异。研究结果进一步强调了及时实施有效和个性化的初级预防战略的重要性。

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