Cardiovascular Health of U.S. Early Adolescents Assessed by the Life’s Essential 8 Metric

Objectives To characterize cardiovascular health (CVH) among U.S. early adolescents using the American Heart Association's Life's Essential 8 (LE8) metric in a large national cohort. Methods A cross-sectional analysis of children aged 10–13 years in the Adolescent Brain Cognitive Development (ABCD) Study was conducted, primarily using data from the Year 2 follow-up (2018–2020), with supplemental Year 3 (2019–2021) data to improve completeness of cardiometabolic measures. LE8 behavioral factors scores (diet, physical activity, nicotine exposure, sleep) and health factors scores (body mass index, blood pressure, blood glucose, blood lipids), as well as overall LE8 scores, were calculated. Descriptive statistics were generated, and sex differences were assessed using Mann-Whitney U tests. Results Among participants with complete LE8 data (N=1,235; mean age 12.0±0.7 years), the mean overall LE8 score was 78.1±10.4. Most adolescents had moderate (52.9%) or high (46.4%) CVH, while very few had low (0.4%) or optimal (0.3%) CVH. The mean behavioral factors score was 66.8±15.9, and the mean health factors score was 88.1±11.8. Overall LE8 scores did not significantly differ by sex; however, males had higher (better) physical activity and body mass index scores but lower (worse) diet, nicotine exposure, sleep, and blood pressure scores compared with females. Conclusions In this national sample of early adolescents, fewer than half demonstrated high CVH based on LE8, and optimal CVH was rare. Poor diet and low physical activity were prominent contributors to suboptimal CVH. These findings highlight early adolescence as a critical window for interventions to improve long-term CVH.