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
. 2025 Jul 15;15(7):e093362.
doi: 10.1136/bmjopen-2024-093362.

Associations between Life's Essential 8 and stroke: findings from NHANES 2005-2018

Zhenyu Shi #  1 , Jiyan Weng #  2 , Shuxuan Wang  1 , Zhenhang Liu  1 , Fuping Wu  1 , Yaqun Wang  3
Affiliations

Associations between Life's Essential 8 and stroke: findings from NHANES 2005-2018

Zhenyu Shi et al. BMJ Open. .

Abstract

Background: Stroke poses a significant financial and medical burden as it is the primary cause of death and disability globally. The identification of modifiable risk factors is crucial in the prevention of stroke. Life's Essential 8 (LE8) is the most recent indicator of cardiovascular health, but its association with stroke is unclear.

Methods: Using information from the National Health and Nutrition Examination Survey conducted in 2005-2018, we evaluated the relationship between the LE8 score and the self-reported incidence of stroke in adult US citizens aged 20 years or older on a cross-sectional basis. LE8 scores were classified as being high, moderate or low according to American Heart Association guidelines. The stroke status was ascertained through self-reporting, and the analysis was adjusted for potential confounders. In addition, restricted cubic spline (RCS) analyses were used to further analyse the potential non-linear correlation between the LE8 score and the risk of stroke.

Results: In our study, a total of 24 851 study participants were included, with 943 strokes and a male prevalence of 48.21%. After adjusting for all covariates, the odds of stroke were 2.17 (95% CI: 1.41 to 3.33) and 4.81 (95% CI: 3.07 to 7.56) in those with medium and low LE8 scores compared with those with a high LE8 score, respectively. Both the health behaviour score and the health factor score exhibit a significant association with stroke risk. RCS further confirmed that the association was linear. Finally, subgroup analysis has further confirmed the robustness of the observed associations.

Conclusions: Our observation suggests an important independent negative association between LE8 score and stroke risk. This study demonstrates the utility of LE8 as a public health tool for stroke risk stratification and emphasises the importance of cardiovascular health in stroke prevention.

Keywords: Cardiovascular Disease; Risk Factors; Stroke.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. The flow chart of participant selection. LE8, Life’s Essential 8.
Figure 2
Figure 2. (A) Restricted spline curves of LE8 score for stroke. (B) Health behaviour score for stroke. (C) Health factor score for stroke. LE8, Life’s Essential 8.
Figure 3
Figure 3. Subgroup analysis of multivariable adjusted association of LE8 score with the risk of stroke. LE8, Life’s Essential 8.
See this image and copyright information in PMC

References

    1. Wang Y, Wang J, Chen S, et al. Different Changing Patterns for Stroke Subtype Mortality Attributable to High Sodium Intake in China During 1990 to 2019. Stroke. 2023;54:1078–87. doi: 10.1161/STROKEAHA.122.040848. - DOI - PubMed
    1. Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396:1204–22. doi: 10.1016/S0140-6736(20)30925-9. - DOI - PMC - PubMed
    1. Santos AC, Willumsen J, Meheus F, et al. The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis. Lancet Glob Health. 2023;11:e32–9. doi: 10.1016/S2214-109X(22)00464-8. - DOI - PMC - PubMed
    1. Feigin VL, Owolabi MO, World Stroke Organization–Lancet Neurology Commission Stroke Collaboration Group Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization-Lancet Neurology Commission. Lancet Neurol. 2023;22:1160–206. doi: 10.1016/S1474-4422(23)00277-6. - DOI - PMC - PubMed
    1. Li X-Y, Kong X-M, Yang C-H, et al. Global, regional, and national burden of ischemic stroke, 1990-2021: an analysis of data from the global burden of disease study 2021. EClinicalMedicine. 2024;75:102758. doi: 10.1016/j.eclinm.2024.102758. - DOI - PMC - PubMed

LinkOut - more resources