Relations of Life’s Essential 8 score with arterial and microvascular function: The Jackson Heart Study

Abstract Background Cardiovascular disease (CVD) poses a major burden on the US population, disproportionately impacting African Americans. Vascular function provides a window to assess cumulative risk predisposing individuals to adverse cardiovascular events. The American Heart Association (AHA) Life’s Essential 8 (LE8) provides a means of scoring cardiovascular health, but has yet to be correlated with vascular function. Methods In a sample of Jackson Heart Study participants (N=2,186, mean age 57 years, 65% women), LE8 scores were calculated per AHA guidelines at baseline visits (2000-2004). Noninvasive vascular assessments using arterial tonometry and Doppler ultrasound were performed within an ancillary study (2012-2017). Tests measuring aortic and peripheral arterial stiffness included carotid-femoral pulse wave velocity, carotid brachial pulse wave velocity, carotid-radial pulse wave velocity, central pulse pressure, forward pressure wave, and characteristic impedance. Microvascular function tests included baseline and hyperemic brachial artery flow. Linear regression models, adjusted for age, age 2 , sex and heart rate, examined the association between LE8 score (independent variable) and vascular function (dependent variables). Results In adjusted models, higher LE8 scores were associated with lower carotid-femoral pulse wave velocity (β= -0.32; 95% confidence interval (CI), [-0.42, -0.21]; p