Distribution and influencing factors of cardiovascular health among community inhabitants : Based on the scale of life’s Essential 8

Abstract

Background: Cardiovascular disease remains the leading cause of morbidity and mortality globally. Cardiovascular health measurements are closely associated with cardiovascular outcomes. Cardiovascular health assessments can be significantly beneficial to health across whole life of individuals.

Objective: To investigate the cardiovascular health status, distribution, and influencing factors among community inhabitants of Nanjing City, and to inform the prevention and control of cardiovascular disease.

Methods: From September 2022 to August 2024, a total of 45,901 community-dwelling residents aged 35-79 years in Nanjing City were selected using a multistage, stratified, cluster random sampling method. All participants underwent questionnaire surveys, physical examinations, and laboratory tests. Cardiovascular health was quantitatively assessed using the “Life’s Essential 8” scoring standard, which includes four health behaviors (diet, physical activity, smoking, and sleep) and four health factors (BMI, blood lipids, blood glucose, and blood pressure). A score of <50 was defined as low cardiovascular health, 50-80 as moderate cardiovascular health, and >80 as high cardiovascular health.

Results: The overall cardiovascular health score of the study population was 66.9 ± 12.8. Higher scores were observed in women, married individuals, urban residents, and non-high-risk participants for cardiovascular diseases compared with men, unmarried individuals, rural residents, and high-risk participants (P<0.05). The overall score decreased with increasing age (P<0.05) and increased with higher educational levels (P<0.05). The mean scores of diet, physical activity, smoking, sleep, BMI, blood lipids, blood glucose, and blood pressure were 37.7 ± 31.0, 79.8 ± 38.8, 71.6 ± 40.3, 84.7 ± 24.0, 58.8 ± 31.4, 67.4 ± 29.5, 79.9 ± 25.4, and 45.8 ± 33.9, respectively. Among the study subjects, 7,524 (16.4%) had high cardiovascular health, 34,071 (74.2%) had moderate cardiovascular health, and 4,306 (9.4%) had low cardiovascular health. Multivariable logistic regression analysis showed that, compared with participants with low cardiovascular health, women, those aged 55-64 and 65-79 years, those with junior/senior high school or college and above education, other occupations, and non-high-risk participants were more likely to have moderate cardiovascular health, whereas labour workers, public service employees, administrative employees, and rural residents were less likely to have moderate cardiovascular health (P<0.05). Women, those with junior/senior high school or college and above education, other occupations, and non-high-risk participants were more likely to have high cardiovascular health, whereas participants aged 45-54 or 55-64 years and rural residents were less likely to have high cardiovascular health (P<0.05).

Conclusions Cardiovascular health among community residents in Nanjing is at a moderate level. Males, older people, those with lower education levels, rural residents, and high-risk groups should be prioritized for targeted interventions. Comprehensive improvement in cardiovascular health can be achieved by strengthening interventions on diet, smoking, and blood pressure.

Keywords

Cardiovascular disease / Cardiovascular health / Life’s Essential 8 / Health behaviors / Influencing factors

Declarations

Not applicable.

Authors' contributions

Conceptualization, X.Y. and H.X.; Methodology, X.Y.; Data curation, W.X. and Z.C.; Formal analysis, W.X. and Z.C.;

Funding acquisition, H.X.; Project administration, H.X.; Resources, not applicable; Supervision, H.X.; Validation, H.X.; Writing—original draft, X.Y.; Writing—review and editing, H.X. All authors have read and agreed to the published version of the manuscript.

Ethical approval and consent to participate

The study received approval from Ethics Committee of the Nanjing Center for Disease Control and Prevention (Approval No. PJ2020-B001-01).

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Competing interests

All authors declare that there are no competing interests.

Funding

This work was supported by the Nanjing Municipal Health Science and Technology Development Special Fund (ZKX21054).

Acknowledgements

Not applicable.

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