Association between the American Heart Association's new "Life's Essential 8" metrics and urinary incontinence: a cross-sectional study of NHANES data from 2011 to 2018

Background: Urinary incontinence (UI), as one of the five major global diseases, has seen a continuous rise in incidence, resulting in significant medical costs and societal burden. The American Heart Association (AHA) established the criteria of ideal cardiovascular health (CVH). and established the Life's Essential 8 (LE8) score to reduce the risk of cardiovascular mortality. UI shares several common risk factors with cardiovascular diseases (CVDs). This study aimed to investigate the association between LE8 score and the incidence of UI, extending the impact of CVH. Methods: We examined data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018, which included 17,269 US adults over the age of 20. The LE8 score classified CVH into three categories: poor, intermediate, and perfect. Logistic regression was performed to investigate the relationship between CVH status and the incidence of UI. Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regression were utilised to figure out which essential aspects from LE8 infect the UI the most. Results: The participants in this study had an average age of 49.21 years, with 50.28% being female. The number of participants with poor, intermediate, and perfect CVH was 1,797, 11,721, and 3,751, respectively. After adjusting for related confounding factors, optimal CVH was associated with a decreased incidence of UI compared to bad CVH (adjusted odds ratio: 0.495, 95% confidence interval: 0.432-0.567, P<0.001). Moreover, the body mass index (BMI) score and physical activity score among the CVH metrics were significantly and positively associated with UI prevention, while the effects of the other metrics were not evident. Conclusions: In the current study, ideal CVH was associated with a lower incidence of UI, which can be an indicator of a healthy lifestyle. Better BMI and activity status are two key preventing factors for UI.