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Background: Since many cardiovascular risk factors originate early in life and track into adulthood, childhood represents a critical period for primordial prevention. To address cardiovascular health (CVH) across the life course, the American Heart Association (AHA) introduced the Life’s Essential 8 (LE8) framework, integrating the health components diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids, blood glucose and blood pressure into a composite CVH score. While population-based research using LE8 in international paediatric populations is increasing, the framework has not yet been applied to German data.

Aim/scientific question: As a first step in a larger project on LE8, we investigate how the AHA operationalisation of LE8 in children and adolescents can be applied conceptually and in terms of data availability in the German context.

Material & Methods: The analyses are performed on population-based data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), obtained during the baseline study (2003–2006). We develop and compare two operationalisations based on available national data: 1) following the AHA definitions and 2) using German reference values and guidelines.

Results: There are some differences between the clinical guidelines established in Germany and the operationalisations defined by the AHA. In the case of the percentile-based classifications, the reference populations differ, which is particularly relevant for measures such as body mass index (BMI) and blood pressure (BP), since their classification depends on population-specific distributions. Additionally, criteria for BP assessment vary with respect to the age threshold for applying adult cut-offs, with a threshold of 16 years in Germany compared to 13 years in the AHA framework. Furthermore, the number of classification categories differs; for example, the AHA operational definition for the lipid score distinguishes five levels, whereas German guidelines define only three.

Discussion: Preliminary results indicate that the LE8 operationalisation needs some adaptations to the German context and available data. Applying the LE8 framework for the early stage of life in Germany therefore requires a balance between international comparability and national relevance.

Take Home Message: The LE8 concept is a promising tool for assessing cardiovascular health among children and adolescents at the population level, provided that the challenges associated with its operationalisation are adequately addressed.

Competing interests: None