Association of cardiovascular health and endothelial function in adult females

Abstract

Cardiovascular disease (CVD) remains the leading cause of death globally and in the United States, with modifiable risk factors playing a substantial role in disease progression. The American Heart Association’s Life’s Essential 8 framework offers a comprehensive approach to assessing cardiovascular health (CVH) by integrating four health behaviors and four health factors. While CVH as defined by Life’s Essential 8 has been linked to various clinical outcomes, its relationship with physiological markers such as endothelial function has not been well explored. Endothelial function, a key indicator of vascular health, can be measured non-invasively using flow-mediated dilation (FMD). Thus, the purpose of this study was to examine the association between overall CVH, based upon the Life’s Essential 8 construct, and endothelial function, assessed via FMD, in adults with at least two CVD risk factors. ☐ A total of 35 adult females were included in this analysis of baseline data from a randomized controlled trial. CVH score was assessed using Life’s Essential 8 scoring system, with each metric ranging from 0 to 100 and averaged to calculate overall CVH. Brachial artery FMD was measured following standardized protocols, with allometric scaling applied to FMD percent to account for differences in the baseline artery diameter. Linear regression analyses indicated a significant positive association between overall CVH score and corrected FMD (b = 0.10 ± 0.05, p = 0.037). Blood pressure was the only individual CVH metric independently associated with FMD. Findings suggest that CVH, when assessed as a composite score, may offer meaningful insight into early endothelial health. The results highlight the potential utility of Life’s Essential 8 as a practical tool for identifying individuals at increased cardiovascular risk prior to clinical disease onset.