{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:35Z","timestamp":1789715015005,"version":"4.0.1"},"reference-count":69,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Life\u2019s Essential 8 provides a comprehensive framework linking modifiable behavioral and biological factors to cardiovascular risk. This study evaluated a multimediation model to explain how low income is associated with cardiovascular risk indexed by blood pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">National Health and Nutrition Examination Survey (2021\u20132023) data were analyzed among community\u2010dwelling US adults (n=3345). A multimediation path analysis tested a behavioral\u2010to\u2010biological pathway from income through health behaviors (moderate\u2010to\u2010vigorous physical activity [MVPA], sleep, nutrition, and smoking) to biological measures (body mass index, low\u2010density lipoprotein cholesterol, and fasting glucose), with systolic blood pressure as the end point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Low income was associated with lower MVPA (\u03b2=0.11,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), lower nutrition (\u03b2=0.11,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and increase in smoking (\u03b2=0.40,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Total indirect effects indicated that low income was associated with higher fasting glucose (\u03b2=\u22120.10 [95% CI, \u22120.128 to \u22120.066];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010), body mass index (\u03b2=\u22120.10, [95% CI, \u22120.134 to \u22120.069];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006), and systolic blood pressure (\u03b2=\u22120.12 [95% CI, \u22120.146 to \u22120.088];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006). Low MVPA was associated with higher systolic blood pressure (\u03b2=\u22120.03 [95% CI, \u22120.056 to 0.000];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.048), fasting glucose (\u03b2=\u22120.07,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and body mass index (\u03b2=\u22120.08,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Low income was associated with unhealthy behaviors and indirect associations with adverse biological outcomes and elevated systolic blood pressure. MVPA demonstrated the strongest behavioral association, suggesting that promoting MVPA may mitigate income\u2010related cardiovascular risk and inform community\u2010based trials among low\u2010income individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043789","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:06:21Z","timestamp":1778756781000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Model Analysis of the American Heart Association\u2019s Life\u2019s Essential 8: Can Physical Activity Mitigate Cardiovascular Risk Among Low\u2010Income Individuals?"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5844-5764","authenticated-orcid":false,"given":"Donya","family":"Nemati","sequence":"first","affiliation":[{"name":"The Ohio State University","place":["Columbus, 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