A nationwide study led by UAB researchers showed that cardiovascular health in young adults did not improve from 2007-2018 and only one in four people in that age group have ideal cardiovascular health.Physician-scientists at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine published a study in the American Journal of Preventive Cardiology that assessed cardiovascular health in young adults. The findings of this study suggest that CVH in young adults did not improve from 2007-2018 and only a fourth of individuals have ideal cardiovascular health.
“Young adults tend to neglect their CVH as cardiovascular disease is considered a problem of older adults,” said Naman S. Shetty, M.D., a research fellow in the UAB Division of Cardiovascular Disease and the first author of this manuscript. “However, this study notes that about three-fourths of all young adults have less than ideal CVH. The effects of poor CVH in young adults may not be immediately apparent, but these individuals are at a substantially higher risk of cardiovascular disease in the future.”
In 2022, the American Heart Association introduced the Life’s Essential 8 score to improve the measurement of CVH. The LE8 has eight components, including sleep, smoking, body mass index, physical activity, cholesterol levels, healthy diet, blood pressure and fasting blood glucose levels. These components are measured on a scale from 0 to 100. The previous tool for CVH measurement, the Life’s Simple 7 score, did not incorporate sleep as one of the components. The addition of sleep as a component of CVH and measurement of CVH on a scale of 0 to 100 improve the quantification of the CVH, enable presentation of the CVH in a comprehensible form and allow more sensitive tracking of CVH over time.
Naman S. Shetty, M.D., a research fellow in the UAB Division of Cardiovascular Disease and the first author of this manuscriptShetty and his team used the National Health and Nutrition Examination Survey data for American adults ages 18-44 years from 2007-2018 for their analysis. Using this database allowed the team to generate nationwide population-level estimates of the CVH of approximately 89.4 million young adults in America. The research team found that using the LE8 score in young adults classified only 21.1 million individuals as having ideal CVH compared with 40.1 million using the LS7 score. Furthermore, the CVH had not improved over a decade. Blood pressure, body mass index and blood sugar scores declined over the 10-year study period.
Females had better overall CVH and component scores compared with males. The study attributed these differences to socio-demographic factors such as a higher number of health care visits and higher insurance rates in females.
Moreover, the study also noted race-based differences in the CVH of young adults. Pankaj Arora, M.D., the senior author of the manuscript and an associate professor in the UAB Division of Cardiovascular Disease, says that Black individuals had the lowest scores in the overall LE8 score and the lowest scores in the components of blood pressure, blood sugar and sleep compared with other racial groups. Though these findings are concerning, researchers say they enable targeted approaches to improve CVH in Black individuals and reduce the disparity in CVH. Focusing efforts on young adults would also directly help to reduce the enormous burden of heart disease in Black individuals.
Pankaj Arora, M.D., the senior author of the manuscript and an associate professor in the UAB Division of Cardiovascular Disease“Risk prediction in young adults to prevent cardiovascular events has been a long-standing focus of our research group,” Arora said.
Arora says poor sleep has been known to be associated with cardiovascular disease.
“Integration of sleep in the Life’s Essential 8 score for measuring CVH has led to alarming changes in the categorization of CVH,” Arora said. “Accounting for sleep as a determinant of CVH reclassified about half of the individuals classified as ideal CVH previously to a lower category.”
Arora suggests changes at an individual and population level to improve CVH in young adults. At the individual level, screening and control of factors such as blood glucose levels, blood pressure and blood cholesterol levels should be promoted. At a population level, improved access to health care, incentivizing physical activity, increased taxation of junk food, tobacco products and sweetened beverages, and subsidizing healthy foods may help improve CVH in young adults.