ISC 2024 | Life’s essential 8 scores and brain health clinical outcomes in middle-aged adults
Santiago Clocchiatti-Tuozzo, MD, Yale School of Medicine, New Haven, CT, discusses research exploring the relationship between cardiovascular risk in middle life and their connection to brain health in later life. The study aimed to understand how the American Heart Association’s Life’s Essential Eight (LE8) scores correlated with key brain health endpoints such as stroke, dementia, and late-life depression. LE8 scores reflect overall cardiovascular health based on the LE8 components: blood pressure, glucose, and cholesterol, body mass index, smoking, physical activity, diet, and sleep duration. Using data from the UK Biobank and the All of Us research program, the study found that poorer LE8 profiles were strongly associated with a higher risk of developing stroke, dementia, or depression over a five-year period. All individuals with a history of these events at baseline were excluded, implying the significance of the impact of cardiovascular health on long-term brain health outcomes. The study contributes valuable insights to the understanding of preventive measures for brain health in connection with cardiovascular well-being. This interview occurred during the International Stroke Conference 2024 in Phoenix, AZ.
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Transcript (edited for clarity)
So in this study, we focused on how cardiovascular risk factors ascertained by the Life’s Essential 8, which is a sort of novel, it has been around two years, public and research health construct devised by the American Heart Association that basically encompasses the eight most important pillars of cardiovascular health and always done from a preventive point of view. So we’re understanding blood pressure, not as if you do or you don’t have hypertension, but basically your numbers of systolic blood pressure and diastolic blood pressure...
So in this study, we focused on how cardiovascular risk factors ascertained by the Life’s Essential 8, which is a sort of novel, it has been around two years, public and research health construct devised by the American Heart Association that basically encompasses the eight most important pillars of cardiovascular health and always done from a preventive point of view. So we’re understanding blood pressure, not as if you do or you don’t have hypertension, but basically your numbers of systolic blood pressure and diastolic blood pressure. The same with blood glucose. Not if you have or if you don’t have diabetes, but your levels of blood glucose and so on and so forth.
Lately in science we have been seeing that cardiovascular health is very strongly linked with poor brain health later in life. So we wanted to understand how this is in a timely cohort of five years which was our follow up. And, of course, we wanted to use a patient centered and comprehensive composite that really encompasses the most important diseases related to poor brain health, which we focused on stroke, we focused on dementia, and late life depression. And for this, we designed a prospective cohort study using a discovery phase and a replication phase. In our in our discovery phase, we focused on data from the UK Biobank and in our replication phase, we focused on data from the All of Us research program. So the UK Biobank is known by many out there. It’s an incredible and massive study being done in the UK. They have enrolled approximately half a million participants and have all sorts and types of data about them. It’s actually an amazing study. And on the other hand, we have the All of Us research program, which is a very, very similar study being now performed in the United States, endorsed by the National Institutes of Health, with a very similar narrative, a prospective study done within the United States, volunteer based, but trying to reduce the known disparities that exist in science and that affect mostly minorities in research. So for that reason, they aim to enroll a million Americans and, of course, try to reduce these disparities that have been affecting science as a whole.
So we designed this prospective cohort study with our both stages. We focused on our exposure, the Life’s Essential 8 score, which we divided into categories of optimal, intermediate, and poor. And after following our participants for five years, we indeed found in our results that having intermediate or poor cardiovascular health, as ascertained by the Life’s Essential 8, and when being compared to optimal, would indeed correlate with higher and higher rates and risk of this composite of the most important diseases related to poor brain health.
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