J Am Heart Assoc. 2026 May 13:e046898. doi: 10.1161/JAHA.125.046898. Online ahead of print.
ABSTRACT
BACKGROUND: This study assessed cardiovascular health in women using the American Heart Association's Life's Essential 8 (LE8) score, and compared cardiovascular health across premenopausal, perimenopausal, and postmenopausal stages.
METHODS: Data from the National Health and Nutritional Examination Survey cycles 2007 to 2020 were used and included women aged 18 to 80 years who were not pregnant or breastfeeding and without prior cardiovascular disease. Menopausal status was classified as pre-, peri-, or postmenopausal. LE8 scores were calculated as the continuous mean of 8 component scores and also categorized as poor, intermediate, or ideal. National Health and Nutritional Examination Survey analytical guidelines were followed. Adjusted linear regression models were used to assess temporal trends.
RESULTS: A total of 9248 women were included in the final sample. In crude analyses, continuous median LE8 scores declined with advancing reproductive stage: 73.3 (premenopause), 69.1 (perimenopause), and 63.9 (postmenopause). Diet consistently received the lowest component score, while sleep received the highest. Across all stages, diet scores declined over time (P<0.001). Worsening body mass index scores were observed in pre- and postmenopausal women (P<0.001), while lipid and sleep scores improved in these groups (P<0.001). In comparison with premenopausal women, perimenopausal women were found to have higher age-adjusted odds of categorical poor overall LE8 (adjusted odds ratio, 1.92 [95% CI, 1.13-3.26]), poor lipid score (adjusted odds ratio, 1.76 [95% CI, 1.12-2.76]), and poor glucose score (adjusted odds ratio, 1.83 [95% CI, 1.06-3.17]).
CONCLUSIONS: A decline in crude overall LE8 scores was observed from pre- to postmenopause, but age-adjusted categorical analyses showed the highest odds of poor LE8 scores and poor lipid and glucose scores in perimenopause.
PMID:42125841 | DOI:10.1161/JAHA.125.046898