Overview

• In a JAMA Network Open analysis of 4,241 CARDIA participants followed from ages 18–30, unfavorable or declining heart‑health patterns were linked to higher rates of later cardiovascular disease.
• Researchers identified four 20‑year Life’s Essential 8 trajectories with escalating risk versus the persistently high group: persistently moderate (aHR 2.15), moderate declining (aHR 5.25), and moderate‑to‑low declining (aHR 9.96).
• Every 10‑point drop in the 0–100 Life’s Essential 8 score between years 0 and 20 corresponded to a 53% increase in subsequent cardiovascular disease risk.
• A secondary analysis found stable high cardiovascular health was associated with lower risk than stable moderate (aHR 0.25), while stable low conferred markedly higher risk (aHR 5.91).
• Outcomes were a composite of myocardial infarction, heart failure, stroke, coronary revascularization, or cardiovascular death after year 20, reinforcing calls for early‑adult interventions to maintain or improve Life’s Essential 8 scores.