Korean Cardiovascular Health Status Assessed by Life's Essential 8 in Korean Adult Population: Based on Data From the Korean National Health and Nutrition Examination Survey 2014-2021

Abstract

Background and objectives: Cardiovascular disease is a leading cause of mortality globally and in South Korea. The American Heart Association (AHA) developed Life's Essential 8 (LE8) to evaluate cardiovascular health (CVH) through 8 metrics. However, LE8 has not been studied in the Korean population. This study aims to assess CVH in Korean adults using LE8 metrics and Korea National Health and Nutrition Examination Survey (KNHANES) data.

Methods: This cross-sectional study analyzed 35,117 adults from KNHANES (2014-2021). CVH scores were calculated across 8 metrics (diet, physical activity [PA], nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure) and classified as high (80-100), moderate (50-79), or low (0-49). Demographic, socioeconomic, and clinical characteristics were compared across categories.

Results: Among 35,117 participants (weighted population: 30,544,496; 51.6% women), the mean CVH score was 63.1±0.1, with women scoring higher than men (66.9 vs. 59.1; p<0.001). Only 12.3% achieved high CVH, while 17.7% were classified as low. Diet and PA had the lowest scores, while sleep and blood glucose scored highest. Women demonstrated higher scores than men except in PA. Low CVH was associated with older age (≥65 years: 19.5% low vs. 4.4% in 19-39 years), lower socioeconomic status (68.2% low vs. 31.8% high education), and chronic diseases (e.g., hypertension, diabetes).

Conclusions: This first application of AHA's LE8 metrics to Korean adults revealed suboptimal CVH with significant disparities by age, gender, socioeconomic status, and chronic diseases, emphasizing the need for targeted interventions.

Keywords: Cardiovascular diseases; Lifestyle risk reduction; Primary prevention.

Figure 1. Selection of study populations.

Figure 2. Cardiovascular health score by characteristics of Korean adults. The cardiovascular health scores based on different age groups, the presence of chronic diseases, socioeconomic levels, living arrangements, and patterns of alcohol consumption. Continuous variables were presented as mean ± standard error, and categorical variables were expressed as percentages with 95% confidence intervals.

HTN = hypertension.

Figure 3. Trends in Life’s Essential 8 CVH scores by time period (2014–2021).

BMI = body mass index; CVH = cardiovascular health.