Functional and Circulating Indicators of Endothelial Health and Their Associations With the American Heart Association’s Life’s Essential 8

The American Heart Association's Life's Essential 8 (LE8) is comprised of both biological and behavioral measures, and it predicts cardiovascular disease (CVD). Presently, however, its relation to measures of endothelial function implicated in CVD risk is unclear. In 318 midlife adults (198 female; 55 non-white, M = 42.3 years), endothelial activity was indexed by forearm blood flow (FBF) induced by reactive hyperemia, as well as circulating cellular adhesion molecules (VCAM-1, ICAM-1). LE8 measures included fasting glucose and non-HDL cholesterol, seated blood pressure, body mass index, diet quality, smoking and sleep duration (the latter assessed with self-report inventories). Multiple regression models revealed that lower LE8 scores were related to higher ICAM-1 concentrations (r = -0.41, <i>P</i> < 0.001), but not VCAM-1 (r = -0.06, <i>P</i> > 0.05). Higher LE8 scores were related to a higher FBF %-increase induced by reactive hyperemia (r = 0.29, <i>P</i> < 0.001). Findings suggest that LE8 scores relate to non-invasive and cellular markers of endothelial activity among otherwise healthy midlife adults. Longitudinal studies are needed to understand the divergent associations of LE8 with ICAM-1 and VCAM-1, and to determine if changes in LE8 predict future endothelial health or other contributors to atherosclerotic CVD.