Introduction:
Previous research has established a connection between depression and an elevated risk of cardiovascular disease. In this study, we sought to examine the association between Life’s Essential 8 (LE8), an updated metric for assessing cardiovascular health, and the prevalence and severity of depressive symptoms.

Material and methods:
This investigation draws on data from 29 100 participants in the 2005-2018 National Health and Nutrition Examination Survey. LE8 was determined by eight metrics (diet, physical activity (PA), nicotine exposure, sleep quality, body mass index, blood lipid levels, blood glucose, and blood pressure (BP)), and was characterized as low, moderate, and high cardiovascular health (CVH). We examined the association between LE8 scores and depression using multivariate logistic regression, adjusting for a range of sociodemographic, lifestyle, and health-related variables.

Results:
Higher LE8 scores and CVH levels were associated with lower odds of depression. Each additional LE8 point correlated with 5% lower odds of depression (p < 0.05). Participants with low CVH had over 8-fold higher odds of depression compared to those with high CVH (p < 0.05). Those with moderate CVH had around 3-fold higher odds versus high CVH (p < 0.05). These associations persisted after adjustment for sociodemographics, health behaviors, and clinical variables. A higher LE8 displayed a negative association with all-cause mortality (HR = 0.975, 95% CI: 0.972, 0.978, p < 0.0001) and cardiovascular mortality (HR = 0.987, 95% CI: 0.981,0.993, p < 0.0001).

Conclusions:
Higher adherence to LE8 lifestyle recommendations was associated with lower odds of depression in a nationally representative sample. Promoting LE8 may be an effective public health strategy to prevent depression.