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cohort·cardiology, pediatrics, epidemiology, public health, nutrition·PMC10356051

Validation of “Life's Essential 8” Metrics With Cardiovascular Structural Status in Children: The PROC Study in China

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease · 9 authors, 3 centres

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LE8 cardiovascular health metrics were assessed via questionnaire and echocardiographic measurements of LVM, LVMI, and cIMT.

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LE8 cardiovascular health metrics were assessed via questionnaire and echocardiographic measurements of LVM, LVMI, and cIMT. Mean CVH scores declined from baseline to follow-up, with diet showing the lowest perfect-score prevalence (5.1%), only 18.6% of children meeting physical activity recommendations, and 55.9% exposed to nicotine via household smokers. Overweight/obesity prevalence rose from 26.8% to 38.2%. Children with low CVH scores had significantly higher LVM (67.9 g), LVMI (37.1 g/m^2.7^), and cIMT (0.37 mm) compared with high CVH scores (56.8 g, 33.2 g/m^2.7^, 0.35 mm), with associations remaining significant after age and sex adjustment. Findings support the validity of LE8 metrics for assessing cardiovascular health in children.

STUDY TYPE

cohort

SPECIALTY

cardiology

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ORIGINAL PAPER

PMC10356051

Validation of “Life's Essential 8” Metrics With Cardiovascular Structural Status in Children: The PROC Study in China

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

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ABSTRACT

Abstract Background Life's Essential 8 (LE8) metrics for cardiovascular health (CVH) aid primordial prevention in US populations. Methods and Results We conducted a child cohort study (PROC [Beijing Child Growth and Health Cohort]) with baseline (2018–2019) and follow‐up (2020–2021) assessments, enrolling disease‐free 6‐ to 10‐year‐old children from 6 elementary schools in Beijing. We collected LE8‐assessed components via questionnaire surveys and 3 cardiovascular structural parameters by 2‐dimensional M‐mode echocardiography: left ventricular mass (LVM), LVM index, and carotid intima‐media thickness. Compared with 1914 participants (mean age, 6.6 years) at baseline, we saw lower mean CVH scores at follow‐up (n=1789; 8.5 years). Among LE8 components, diet presented the lowest perfect‐score prevalence (5.1%). Only 18.6% of participants had physical activity ≥420 min/wk, 55.9% had nicotine exposure, and 25.2% had abnormal sleep duration. Prevalence of overweight/obesity was 26.8% at baseline and 38.2% at follow‐up. We noted optimal blood lipid scores in 30.7%, while 12.9% of children had abnormal fasting glucose. Normal BP was 71.6% at baseline and 60.3% at follow‐up. LVM (g), LVM index (g/m 2.7 ), and carotid intima‐media thickness (mm) were significantly lower in children with high (56.8, 33.2, 0.35) or moderate CVH scores (60.6, 34.6, 0.36), compared with children with low CVH scores (67.9, 37.1, 0.37). Adjusting for age/sex, LVM (β=11.8 [95% CI, 3.5–20.0]; P =0.005), LVM index (β=4.4 [95% CI, 0.5–8.3]; P =0.027), and carotid intima‐media thickness (β=0.016 [95% CI, 0.002–0.030]; P =0.028) were higher in the low‐CVH group. Conclusions CVH scores were suboptimal, declining with age. LE8 metrics indicated worse CVH in children with abnormal cardiovascular structural measurements, suggesting the validity of LE8 in assessing child CVH. Registration URL: https://www.chictr.org.cn/index.html ; Unique identifier: ChiCTR2100044027. Keywords: cardiovascular health, children, cohort study, Life's Essential 8 Subject Categories: Diet and Nutrition, Epidemiology, Exercise, Lifestyle, Obesity

CITATION EXPORT

Wen Shu, Menglong Li, Huidi Xiao et al.. Validation of “Life's Essential 8” Metrics With Cardiovascular Structural Status in Children: The PROC Study in China. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. (2023). https://doi.org/10.1161/JAHA.122.029077

AUTHORS

9 · 3 CENTRES

Wen Shu, Menglong Li, Huidi Xiao, Nubiya Amaerjiang, Nourhan M Khattab, Jiawulan Zunong, Mengying Guan, Sten H Vermund, Yifei Hu

1 Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
2 Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
3 Yale School of Public Health, Yale University, New Haven, CT, USA