Global prevalence of cardiovascular risk factors based on the Life's Essential 8 score: an overview of systematic reviews and meta-analysis

Cardiovascular health (CVH) is a critical issue for global health. However, no previous study has determined the prevalence of cardiovascular risk factors based on the American Heart Association’s (AHA) Life’s Essential 8 (LE8). Therefore, we aimed to estimate the global prevalence of the eight cardiovascular risk factors identified in the LE8. A systematic search of systematic reviews with meta-analysis on cardiovascular risk factors covering data reported between 2000 and 2019 was conducted on PubMed, Epistemonikos, and the Cochrane Library until 1 May 2023. After applying exclusion criteria, 79 studies remained in the final selection for the narrative synthesis in the systematic review, of which 33 of them were used in the meta-analysis which included 2 555 639 participants from 104 countries. The overall pooled prevalence of cardiovascular risk factors was as follows: insufficient physical activity, 26.3% (95% CI 2.3%–63.4%), no adherence to a healthy diet, 34.1% (95% CI 5.8%–71.2%), nicotine exposure, 15.4% (95% CI 10.4%–21.2%), insufficient sleep quality, 38.5% (95% CI 14.0%–66.7%), obesity, 17.3% (95% CI 6.1%–32.6%), dyslipidemia, 34.1% (95% CI 33.8%–34.4%), diabetes, 12.0% (95% CI 7.0%–18.2%), and hypertension, 29.4% (95% CI 23.3%–35.8%). These results warrant prevention strategies aimed at reducing insufficient sleep quality, and no adherence to a healthy diet as leading cardiovascular risk factors worldwide. The high prevalence of hypertension among children and adults is concerning and should also be adequately addressed through global policies.