Abstract Body: Background: The AHA uses “Life’s Essential 8 (LE8)” to quantify cardiovascular health (CVH). These metrics assess eight essential components of nicotine exposure, sleep duration, physical activity, diet, body mass index, lipid levels, blood glucose, and blood pressure to calculate a CVH score. However, little is known about LE8 scores in patients with history of stroke compared to the general population.

Methods: Data was included on individuals aged 18 and older who participated in the National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2018. A LE8 score ranging from 0 (lowest) to 100 (highest) was calculated for all participants. Subscores of 0 to 100 points were also calculated for each of the metrics. The total LE and individual metric scores of participants with a self-reported history of stroke were compared to those who did not. The characteristics of all participants were stratified across age, gender, race/ethnicity, poverty/income ratio (PIR), education level, insurance status, alcohol consumption, high cholesterol, high high density lipoprotein, and histories of hypertension, diabetes, and/or myocardial infarction.

Results: 1,019 participants self-reported a history of stroke of 27,670 total participants. When adjusted for age, sex, race/ethnicity, education and PIR, the mean LE8 score was significantly lower in those who reported a history of stroke at (59.2, 95% CI, 57.8-60.5) compared to those who did not (63.8, 95% CI, 63.4-64.2) in those who did not. Stroke survivors had significantly lower mean subscores in 6 of 8 metrics on nicotine exposure (range 66.2-71.5), blood glucose (range 70.8-74.7), physical activity (range 30.8-36.9), diet (range 35.3-40.1), sleep duration (range 73.3-77.7), and blood pressure (range 58-62.4) compared to other participants (p<.001). Conversely, stroke survivors had higher mean lipid subscore (range 66.8-71.6) compared to other participants (range 63.0-64.3). In contrast to general participants who showed improvements over time in smoking, lipid levels, and sleep subscores, stroke survivors did not exhibit significant changes over time in any of these scores.

Conclusions: Stroke survivors have inferior overall cardiovascular health and lower total LE8 scores compared to the general population. More intensive and tailored secondary stroke interventions are necessary to ensure improvement in overall cardiovascular health among stroke survivors.