Abstract 4146319: Racial Disparities and Driving Factors in the AHA's Life's Essential 8 Among American Adults: Insights from NHANES 2011-2020

Backgrounds: The AHA introduced "Life's Essential 8" (LE8) in 2022 as a comprehensive metric to facilitate detailed tracking and management of cardiovascular health (CVH) at the population level. However, the racial/ethnic differences in LE8, how these differences change over time, and the driving factors of LE8 in each subgroup remain unclear. Methods: We utilized data from the continuous NHANES from 2011 to 2020 to examine racial disparities and driving factors in the AHA's LE8 among American adults. To ensure national representation, appropriate weights were applied. Survey-weighted and age-standardized trends in LE8 scores by racial and ethnic groups were analyzed using generalized linear models (GLMs). To identify the driving factors—specific metrics influencing the LE8 overall score—we calculated z-scores for all components. Then we used the spider chart to visualize the driving factors. Results: A total of 13,915 adult were included, of whom the mean age is 47.9 ± 0.37 years, 6,612 (47.55%) were women, 3,485 (14.63%) were Hispanics, 5,335 (69.74%) were non-Hispanic Whites, 3,464 (10.82%) were non-Hispanic Blacks, and 1,631 (4.81%) were Asians. From 2011-2020, the LE8 scores did not change significantly overall and across all racial groups (all p-trend > 0.10, Figure 1 ). During the study period, racial/ethnic disparity persisted with Asian adults consistently having the highest LE8 scores and Black adults having the lowest scores. Notably, the lower LE8 scores in Black adults were primarily driven by lower scores of diet, blood pressure, and sleep health, whereas the higher LE8 scores in Asian adults primarily driven by higher scores of diet, nicotine exposure, and BMI. The LE8 scores in White adults were primarily driven by blood glucose and physical activity and the LE8 score in Hispanic adults were primarily driven by blood pressure ( Figure 2-A ). In 2017-2020 ( Figure 2-B ), Black adults had the lowest scores for all LE8 components, except for blood lipids. In contrast, Asian adults had the highest scores in diet, physical activity, nicotine exposure, and sleep health. Throughout the study period, the racial/ethnic disparity in LE8 score did not change significantly (all p >0.10). Conclusion: We found persistent racial disparities in cardiovascular health among U.S. adults, with Black adults having the lowest LE8 scores in almost all components. The driving factors for LE8 scores varied by racial subgroups, emphasizing the need for targeted interventions.