American Heart Association Life's Essential 8 and Heart Failure in Black Individuals: An Analysis of the National Health and Nutrition Examination Survey
4 affiliations
- 1Northwestern University
- 2Virtua Heart Failure Program, Virtua Health
- 3Massachusetts General Hospital
- 4MedStar Heart Institute, MedStar Family Choice
Abstract
Background Self‐reported Black individuals have a disproportionately high prevalence of heart failure (HF) compared with other racial groups. In an effort to empower patients and health providers to combat cardiovascular disease, the American Heart Association identified Life's Essential 8 as the 8 health behaviors crucial for heart health. In this study, we evaluate the association between components of Life's Essential 8 and HF outcomes among Black individuals. Methods This cross‐sectional observational study analyzed 107 622 individuals captured in the NHANES (National Health and Nutrition Examination Survey) from 1999 to 2020 who were categorized by self‐reported race. To represent Life's Essential 8, variables of self‐reported sleep duration, physical activity, smoking status, and dietary habits were used. Additionally, self‐reported diagnoses of diabetes, hyperlipidemia, hypertension, and heart failure were included. Multivariable logistic regression models were constructed to estimate odds ratios (ORs) and 95% CIs for the associations between Life's Essential 8 components and HF among Black individuals. Results Black individuals were diagnosed with HF at a younger age compared with White individuals (54 years vs 65 years, P <0.001). Among Black individuals, body mass index (odds ratio [OR], 1.041 [95% CI, 1.027–1.055], P =0.02), hypertension (OR, 3.175 [95% CI, 2.14–4.69], P <0.0001), hyperlipidemia (OR, 1.36 [95% CI, 1.04–1.76], P =0.02), and diabetes (OR, 2.07 [95% CI, 1.60–2.67], P ≤0.0001) were associated with increased odds of HF. Physical activity was associated with lower odds (OR, 0.564 [95% CI, 0.38–0.836], P =0.004) of HF in Black individuals. Conclusions Black individuals experienced HF at significantly younger ages, with traditional cardiometabolic factors (body mass index, hypertension, hyperlipidemia, diabetes) each independently being associated with HF risk. Physical activity appears protective, underscoring the importance of early, targeted prevention strategies.
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BibTeX
@article{rasberry2026american,
title = {{American Heart Association Life's Essential 8 and Heart Failure in Black Individuals: An Analysis of the National Health and Nutrition Examination Survey}},
author = {Kiersten A. Rasberry and Olisemeka Oputa and Kaleb P. Boyd and Tolulope A. Agunbiade and Toluwalase A. Awoyemi and Jing Gao and Rebecca S. Harap and Tingqing Wu and Kamari Ositelu and Oluseyi Princewill and Quentin R. Youmans and Alana A. Lewis and Ike S. Okwuosa},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.126.049656},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.049656},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - American Heart Association Life's Essential 8 and Heart Failure in Black Individuals: An Analysis of the National Health and Nutrition Examination Survey
AU - Kiersten A. Rasberry
AU - Olisemeka Oputa
AU - Kaleb P. Boyd
AU - Tolulope A. Agunbiade
AU - Toluwalase A. Awoyemi
AU - Jing Gao
AU - Rebecca S. Harap
AU - Tingqing Wu
AU - Kamari Ositelu
AU - Oluseyi Princewill
AU - Quentin R. Youmans
AU - Alana A. Lewis
AU - Ike S. Okwuosa
PY - 2026
DA - 2026/10/20
JO - Journal of the American Heart Association
DO - 10.1161/jaha.126.049656
UR - https://www.ahajournals.org/doi/10.1161/JAHA.126.049656
AB - Background Self‐reported Black individuals have a disproportionately high prevalence of heart failure (HF) compared with other racial groups. In an effort to empower patients and health providers to combat cardiovascular disease, the American Heart Association identified Life's Essential 8 as the 8 health behaviors crucial for heart health. In this study, we evaluate the association between components of Life's Essential 8 and HF outcomes among Black individuals. Methods This cross‐sectional observational study analyzed 107 622 individuals captured in the NHANES (National Health and Nutrition Examination Survey) from 1999 to 2020 who were categorized by self‐reported race. To represent Life's Essential 8, variables of self‐reported sleep duration, physical activity, smoking status, and dietary habits were used. Additionally, self‐reported diagnoses of diabetes, hyperlipidemia, hypertension, and heart failure were included. Multivariable logistic regression models were constructed to estimate odds ratios (ORs) and 95% CIs for the associations between Life's Essential 8 components and HF among Black individuals. Results Black individuals were diagnosed with HF at a younger age compared with White individuals (54 years vs 65 years, P <0.001). Among Black individuals, body mass index (odds ratio [OR], 1.041 [95% CI, 1.027–1.055], P =0.02), hypertension (OR, 3.175 [95% CI, 2.14–4.69], P <0.0001), hyperlipidemia (OR, 1.36 [95% CI, 1.04–1.76], P =0.02), and diabetes (OR, 2.07 [95% CI, 1.60–2.67], P ≤0.0001) were associated with increased odds of HF. Physical activity was associated with lower odds (OR, 0.564 [95% CI, 0.38–0.836], P =0.004) of HF in Black individuals. Conclusions Black individuals experienced HF at significantly younger ages, with traditional cardiometabolic factors (body mass index, hypertension, hyperlipidemia, diabetes) each independently being associated with HF risk. Physical activity appears protective, underscoring the importance of early, targeted prevention strategies.
SN - 2047-9980
ER -