A new nationwide study reveals that only 13% of French adults have optimal heart health. The research, which highlights disparities based on sex, education, and lifestyle, stresses the need for early, targeted prevention.
Published in the American Journal of Preventive Cardiology, the study examined cardiovascular health (CVH) scores among French adults using the American Heart Association’s Life’s Essential 8 (LE8) tool. The LE8 score, ranging from 0 to 100, evaluates factors such as sleep, body mass index (BMI), activity, diet, blood pressure, blood glucose, smoking, and cholesterol levels. Researchers found that rural living, fewer depressive symptoms, lower alcohol consumption, and higher education were linked to higher CVH scores.
Background on Cardiovascular Disease
Despite public health improvements like smoking bans, cardiovascular disease (CVD) remains a leading cause of death globally. CVD accounted for one-third of deaths worldwide and imposed significant economic costs, including €282 billion in the European Union in 2021. However, only 3% of spending focuses on primary prevention. The study emphasizes the importance of primordial prevention, which aims to prevent the development of risk factors for CVD.
The Life’s Essential 8 Score
The LE8 score evaluates eight components: blood glucose, blood pressure, cholesterol, sleep, BMI, nicotine exposure, physical activity, and diet. Researchers assessed these using clinical measurements and self-reported data, including family history, depression, alcohol use, education, and employment. The final LE8 score was categorized as poor (0–49), moderate (50–79), or high (80–100).
Key Findings
The study analyzed data from 191,335 French adults aged 18 to 69, with a mean age of 46.5 years. The average LE8 score was 66.1, with women scoring higher than men (68.9 vs. 62.8). Of the participants, 12.4% achieved high CVH scores, 78.2% had moderate scores, and 9.4% had low scores. Weighted estimates showed that only 11.35% of adults met the threshold for high cardiovascular health.
Education played a significant role, with 4.8% of adults with less than a high school education achieving high CVH scores, compared to 17.8% of those with more than two years of post-high school education. Interestingly, rural residents had slightly higher cardiovascular health scores than urban dwellers, contrary to common beliefs. The study estimates that if all participants achieved high CVH levels, 81% of CVD events could be prevented.
Blood glycemia was the highest-scoring metric (95.5), while diet received the lowest score (41.5). Both men and women had consistently low diet scores, indicating a major public health issue. Men scored lower than women in several areas, including blood pressure and BMI.
Socioeconomic and Lifestyle Factors
Higher LE8 scores were associated with being female, younger, well-educated, living in rural areas, employed in managerial roles, not cohabiting, and reporting fewer depressive symptoms, lower deprivation, and less alcohol consumption. The study found that LE8 scores declined progressively with age, plateauing after 55 years, suggesting the need for age-specific prevention strategies.
Conclusions
This study is the first nationwide analysis of LE8 scores in France, revealing a lower prevalence of high CVH scores compared to the United States (13% vs. 19.6%). French adults scored better in physical activity, BMI, and glycemia, but worse in sleep, blood pressure, and lipid levels. Notably, women were nearly three times more likely than men to achieve high LE8 scores.
The study calls for targeted cardiovascular health interventions, particularly for disadvantaged groups and men. It emphasizes the importance of considering complex factors like sexual minority status and tailoring interventions to specific populations and life stages. The authors advocate for a shift from a care-oriented model to a balanced approach that integrates both care and prevention to improve heart health at the population level.
Related Topics
