Cardiovascular health and carotid atherosclerosis among county residents in henan province: evidence from the le8 scoring system

Objective: To estimate the prevalence of carotid atherosclerosis (CAS) among county residents in Henan Province and to evaluate cardiovascular health (CVH) using the American Heart Association’s Life’s Essential 8 (LE8) score. We assessed associations between CVH and CAS stages to identify disease stages most sensitive to CVH.

Methods: We analyzed baseline data from the Henan Carotid Atherosclerosis and Cardiovascular Diseases Cohort (August 2021–August 2022). A total of 34,176 participants underwent questionnaires, physical examinations, laboratory testing, and carotid ultrasound. CVH was quantified by LE8 and categorized into low, moderate, and high groups. Group comparisons used t-tests, χ² tests or ANOVA. Multivariable logistic regression examined associations between CVH (continuous per 10-point increase and categorical groups) and outcomes: CAS overall, carotid intima–media thickness (CIMT) thickening, carotid plaque, and carotid artery stenosis. Analyses included age- and sex-specific subgroup assessments.

Results: Overall CAS prevalence was 50.58% (n=17,287): CIMT thickening 35.64% (n=12,438), carotid plaque 31.19% (n=10,881), and carotid stenosis 3.57% (n=1,245). Mean LE8 score was 64.74; 13.65% (n=4,666) were high CVH, 73.05% (n=24,967) moderate, and 13.29% (n=4,543) low. Prevalence of CAS and its components varied significantly by age, sex, marital status, education and income (P<0.001). In adjusted models, each 10-point higher CVH score was associated with lower odds of CAS (OR 0.930; 95% CI 0.913–0.947), carotid plaque (OR 0.906; 95% CI 0.8888–0.924), CIMT thickening (OR 0.980; 95% CI 0.962–0.998), and stenosis (OR 0.944; 95% CI 0.901–0.989). Compared with low CVH, high CVH was linked to substantially reduced odds of CAS (OR 0.763; 95% CI 0.696–0.837), plaque (OR 0.662; 95% CI 0.598–0.734) and stenosis (OR 0.660; 95% CI 0.504–0.864). Protective associations were stronger among women and participants ≤65 years.

Conclusions: CAS prevalence is high among county residents in Henan while overall CVH is moderate. Higher LE8 CVH scores are inversely associated with CAS and its advanced stages, particularly carotid plaque and stenosis, with greater benefits observed in women and younger adults. Population-level interventions to improve LE8 metrics may reduce CAS burden.

Dongjie Zhang is a master’s student in Social Medicine and Health Service Management at the School of Public Health, Zhengzhou University. My research focuses on the primary prevention of cardiovascular diseases and the social determinants of health. During my graduate studies, I have contributed to academic monographs and authored or co-authored several research articles in related fields. I have also participated in multiple leading academic conferences in cardiovascular and public health, demonstrating strong research skills and a solid record of academic achievement.