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Background: The concept of cardiovascular health (CVH) is assessed using a score known as Life’s Essential 8 (LE8, fmr. Life’s Simple 7), which was introduced by the American Heart Association (AHA) in 2010. The score was developed as part of the AHA’s strategic goal to improve CVH in the U.S., and it is used in collaboration with the National Institutes of Health to provide statistics on heart disease and stroke risk factors in the U.S. LE8 includes diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids, glucose and blood pressure (BP).

Aim/scientific question: This study investigates the implementation of the LE8 in Germany using national health survey data.

Material & Methods: We examine whether the LE8 components and composite score can be derived from two population-based examination surveys in adults aged 18 to 79 years conducted by the Robert Koch Institute in 1997–98 (GNHIES) and 2008–11 (DEGS1). We develop two operationalisations of the LE8: 1) that follows the AHA health behaviour and health factor definitions and 2) that follows operationalisations used in German guidelines, both considering data availability.

Results: Preliminary results indicate that the guidelines between AHA and Germany align regarding nicotine exposure, body weight and blood glucose. For ideal sleep duration, AHA criteria can be used as no German recommendations exist. There are differences in the classification of BP: the AHA uses 120/80 mmHg for the classification of ideal BP, whilst some current German guidelines use 120/70 mmHg. Blood lipids are classified by non-HDL cholesterol in the LE8, while in Germany LDL is generally used; however, cut-offs are comparable (+30 mg/dL) and consistent with German guidelines.

Discussion: German survey data enable LE8 calculation with minor adaptations to describe CVH of the population in Germany. Under European/German hypertension guidelines, e.g., participants would be classified more strictly for ideal BP than under the AHA classification. In some cases, the cut-offs used to classify individual components may reflect consensus considerations rather than specific outcome-based criteria. However, as LE8 is not an individual risk prediction tool and is not linked to clinical decisions, it has great potential as a tool for monitoring population trends and disparities, and for communicating and promoting the concept of CVH across the lifespan.

Take Home Message: The Life’s essential 8 is a promising tool for assessing cardiovascular health at population level and for monitoring over time in Germany.

Competing interests: None