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 to 2021

Abstract Background Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide, including South Korea. The American Heart Association (AHA) developed Life’s Essential 8 (LE8) to assess cardiovascular health (CVH) comprehensively across eight key metrics. Although LE8 has been validated in various populations, its applicability to the Korean population remains unexplored. Given the increasing prevalence of CVD in Korea due to aging, lifestyle changes, and socioeconomic disparities, evaluating CVH using LE8 can provide critical insights into public health interventions tailored for the Korean population. Purpose This study aims to assess CVH among Korean adults using LE8 metrics based on the Korea National Health and Nutrition Examination Survey (KNHANES) and identify disparities across demographic, socioeconomic, and clinical factors. Methods This cross-sectional study analyzed 35,117 adults aged ≥19 years from KNHANES (2014–2021). LE8 metrics include four health behaviors (diet, physical activity, nicotine exposure, and sleep health) and four health factors (body mass index, blood lipids, blood glucose, and blood pressure). Each metric was scored from 0 to 100, and total CVH scores were categorized as high (80–100), moderate (50–79), or low (0–49). Weighted analyses were performed to assess distributions and associations between CVH scores and key demographic, socioeconomic, and clinical characteristics. 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 significantly higher than men (66.9 vs. 59.1; p0.0001). Only 12.3% achieved high CVH, while 17.7% were classified as low. Diet and physical activity had the lowest mean scores, while sleep health and blood glucose had the highest. Women exhibited higher scores across most metrics except physical activity. Older adults (≥65 years) had significantly lower CVH scores than younger adults (19–39 years) (mean: 58.8 vs. 67.0; p0.0001). Lower socioeconomic status was associated with poorer CVH, with 20.8% of low-income individuals in the lowest CVH category compared to 6.2% in the highest-income group (p0.0001). Chronic conditions such as hypertension (52.1% in low CVH) and diabetes (28.2%) were strongly associated with lower scores. Conclusions This study represents the first application of AHA’s LE8 metrics to a nationally representative Korean population, revealing suboptimal CVH with notable disparities by age, sex, socioeconomic status, and chronic disease prevalence. The findings underscore the urgent need for targeted public health interventions focused on modifiable risk factors, particularly improving diet and physical activity. Future research should explore longitudinal changes in CVH and the effectiveness of tailored interventions to enhance cardiovascular health equity in Korea.