Association Between Life’s Essential 8 Score and Stroke Risk in American Adults

Objective The purpose of this study was designed to assess the correlation between Life’s Essential 8 (LE8) score and the risk of stroke in American adults using data from subjects of the NHANES. Methods Subjects’ data were obtained from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2020.The ..LE8 score integrates health behaviors as well as health factors. We employed weighted multivariate logistic regression models as well as propensity score matching methods to explore the relationship between these health behaviors, health factors, and LE8 scores and stroke risk. In addition, the restricted cubic spline (RCS) technique was used to examine possible nonlinear associations between these variables and stroke risk. Results A total of 31,653 subjects were included in this study, of whom 1187 (3.8%) had stroke. After considering all covariates, the results of weighted logistic regression modeling showed that subjects with intermediate cardiovascular health (CVH) levels had a significantly lower risk of stroke compared to subjects with low CVH levels(OR = 0.5,95%CI:0.41-0.61), while subjects with high CVH levels had a further reduced risk of stroke (OR = 0.29,95%CI:0.16-0.51). After propensity score matching, the results remain consistent with the above.RCS analysis showed a significant nonlinear correlation between LE8 score and stroke risk( P for nonlinear< 0.001). The results of the subgroup analyses were consistent across categories, indicating a significant negative association between LE8 and stroke. Conclusion Among American adults, LE8 scores are negatively associated with stroke risk, which can be reduced through early screening and customized interventions for those with low CVH.