Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 20;12(12):e029077.
doi: 10.1161/JAHA.122.029077. Epub 2023 Jun 10.

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

Wen Shu  1   2 , Menglong Li  1 , Huidi Xiao  1 , Nubiya Amaerjiang  1 , Nourhan M Khattab  1 , Jiawulan Zunong  1 , Mengying Guan  1 , Sten H Vermund  3 , Yifei Hu  1
Affiliations

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

Wen Shu et al. J Am Heart Assoc. .

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/m2.7), 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: Life's Essential 8; cardiovascular health; children; cohort study.

PubMed Disclaimer

Figures

Figure .
Figure .. Cardiovascular health (CVH) total scores and all 8 Life's Essential 8 (LE8) component metric scores by sex at baseline for Chinese children aged 6 to 10 years in PROC (the Beijing Child Growth and Health Cohort).
See this image and copyright information in PMC

References

    1. Wang W, Liu Y, Ye P, Liu J, Yin P, Qi J, You J, Lin L, Wang F, Wang L, et al. Trends and associated factors in place of death among individuals with cardiovascular disease in China, 2008–2020: a population‐based study. Lancet Reg Health West Pac. 2022;21:100383. doi: 10.1016/j.lanwpc.2022.100383 - DOI - PMC - PubMed
    1. Daniels SR, Pratt CA, Hollister EB, Labarthe D, Cohen DA, Walker JR, Beech BM, Balagopal PB, Beebe DW, Gillman MW, et al. Promoting cardiovascular health in early childhood and transitions in childhood through adolescence: a workshop report. J Pediatr. 2019;209:240–251.e241. doi: 10.1016/j.jpeds.2019.01.042 - DOI - PubMed
    1. Zhang Y, Lin C, Liu M, Zhang W, Xun X, Wu J, Li X, Luo Z. Burden and trend of cardiovascular diseases among people under 20 years in China, Western Pacific region, and the world: an analysis of the global burden of disease study in 2019. Front Cardiovasc Med. 2023;10:1067072. doi: 10.3389/fcvm.2023.1067072 - DOI - PMC - PubMed
    1. Zhu Y, Guo P, Zou Z, Li X, Cao M, Ma J, Jing J. Status of cardiovascular health in Chinese children and adolescents: a cross‐sectional study in China. JACC Asia. 2022;2:87–100. doi: 10.1016/j.jacasi.2021.09.007 - DOI - PMC - PubMed
    1. Lloyd‐Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, Greenlund K, Daniels S, Nichol G, Tomaselli GF, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic impact goal through 2020 and beyond. Circulation. 2010;121:586–613. doi: 10.1161/circulationaha.109.192703 - DOI - PubMed

Publication types

LinkOut - more resources