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. 2025 May 15;17(10):1688.
doi: 10.3390/nu17101688.

The Association Between the American Heart Association Life's Essential 8 and Metabolic Syndrome Among Postmenopausal Women: Findings from NHANES 2011-2020

Harshini Meegaswatte  1   2   3 , Andrew J McKune  1   2   3   4 , Demosthenes B Panagiotakos  1   2   5 , Sukhuntha Osiriphun  6 , Noppol Leksawasdi  6   7 , Pornchai Rachtanapun  6   7 , Martin Veysey  8 , Nenad Naumovski  1   2   3   5 , Siraphat Taesuwan  1   2   6   7
Affiliations

The Association Between the American Heart Association Life's Essential 8 and Metabolic Syndrome Among Postmenopausal Women: Findings from NHANES 2011-2020

Harshini Meegaswatte et al. Nutrients. .

Abstract

Background: Postmenopausal women face increased risk of developing metabolic syndrome (MetS) and cardiovascular disease (CVD) due to hormone changes during menopause. Life's Essential 8 (LE8), a relatively new cardiovascular health assessment index by the American Heart Association, may impact MetS diagnostics and potential treatment strategies. This study investigated the association between LE8 and MetS among postmenopausal women. Methods: National Health and Nutrition Examination Survey (NHANES) data were extracted (2011-2020). LE8 comprised eight health behaviours and factors (score of 0-100) classified into low (0-49), moderate (50-79), and high (80-100) cardiovascular health status. MetS was defined as metabolic dysfunctions comprising insulin resistance, central obesity, dyslipidaemia, impaired glucose metabolism, and hypertension. Complex survey-adjusted regression models were used. Effect modification by race and female hormone use were investigated. Results: 5402 postmenopausal women were included (mean age: 63.0 y), and 3152 (58.3%) met MetS criteria. LE8 scores for those with and without MetS were 58 ± 13.8 and 70 ± 14.1 (p < 0.001), respectively (mean ± SD). Higher LE8 scores were associated with lower odds of having MetS (Odds ratio (OR) for a 10-score increase: 0.53, 95% CI: [0.48, 0.57], p < 0.001). Nicotine exposure score was inversely associated with the likelihood of having MetS (0.52 [0.34, 0.80], p = 0.022). The association between LE8 status and odds of MetS differed by race (p-interaction = 0.01); 'moderate' or 'high' cardiovascular health status lowered odds of MetS in all races except other/multi-racial. Conclusions: The inverse relationship between LE8 scores and MetS suggests that integrating LE8 components into management strategies may help prevent CVD in postmenopausal women.

Keywords: Life’s Essential 8; cardiovascular disease; cardiovascular health status; menopause; metabolic syndrome; postmenopausal women.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of the participant sampling process.
Figure 2
Figure 2
Forest plot of the subgroup analysis of Life’s Essential 8 scores with the presence of MetS in each race.
See this image and copyright information in PMC

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