American Heart Association's new “Life's Essential 8” score and depression in adults with chronic diseases and comorbidity: NHANES, 2007 through 2018

Abstract

Objective

The coexistence of depression and chronic diseases might lead to greater disability and increased mortality, and the American Heart Association (AHA) recently proposed Life's Essential 8 (LE8) score to quantify cardiovascular health (CVH). The study aimed to examine the association between LE8 and depression among adults with chronic diseases and comorbidity.

Methods

14,029 adults with chronic diseases from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included in the study. Overall LE8 and subscale scores were categorized into low, moderate, and high groups. Multivariate logistic regressions were applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between LE8 and depression among adults with various chronic diseases and comorbidity.

Results

After adjusting for all covariates, compared to low CVH, high CVH was associated with a significantly lower presence of depressive symptoms among adults with diabetes [OR (95% CI), 0.25 (0.11, 0.58)], hypertension [0.27 (0.20, 0.36)], coronary heart disease [0.16 (0.07, 0.36)], stroke [0.29 (0.11, 0.76)], hyperlipidemia [0.24 (0.20, 0.30)], at least one chronic comorbidity [0.25 (0.21, 0.30)], any single chronic condition [0.28 (0.21, 0.38)], and comorbidities [0.27 (0.19, 0.38)]. Similarly, moderate CVH was also associated with a lower presence of depressive symptoms among adults with various chronic diseases and comorbidities. Dose-response relationships were found, revealing that the ORs for depressive symptoms increased with the decrease of the LE8 score and subscale scores among adults with chronic diseases and comorbidities.

Conclusion

The prevalence of depression increases with decreasing levels of the LE8 and subscale scores among adults with various chronic diseases and comorbidities in the United States.