Depression, a prevalent mood disorder, is distinguished by enduring emotions of sadness, hopelessness, and worthlessness, alongside a diminished inclination towards previously pleasurable activities, thereby significantly impeding the psychosocial functioning of individuals and diminishing their overall quality of life (Thapar et al, 2022). This condition contributes substantially to the worldwide burden of disease, as evidenced by the World Health Organization's classification of major depression as the third most significant cause of global disease burden in 2008, with a projected progression to the foremost position by 2030 (Malhi and Mann, 2018; GBD 2019 Diseases and Injuries Collaborators, 2020). Presently, the treatment modalities for depression encompass psychotherapy, pharmacotherapy, electroconvulsive therapy, and combined therapy. Among these, pharmacotherapy is commonly employed as the primary treatment approach, despite its limited efficacy and numerous adverse effects. Consequently, the significance of preventing depression becomes paramount (Herrman et al, 2022).

Substantial empirical evidence substantiates the interrelation between the brain, mind, heart, and body, which can exert either positive or negative influences on cardiovascular health (CVH), individual cardiovascular disease (CVD) risk factors, and subsequent cardiovascular outcomes, and vice versa.

There exist various direct and indirect mechanisms through which psychological well-being and mental health can impact CVH and the risk of CVD. These mechanisms encompass physiological pathways, such as the inflammatory response, glucose and lipid regulation, and coagulation, which are associated with chronic stress. Additionally, psychological well-being can indirectly affect health behaviors that influence CVH, as well as alter psychosocial resilience factors that either enhance or impede health or mitigate the adverse effects of stressful encounters (Levine et al, 2021; Maia et al, 2008; Schins et al, 2003; von Känel et al, 2006; Slavich and Irwin, 2014; Sumner et al, 2020). However, no investigations have been conducted to examine the correlation between depression and LE8 score. Further investigation is required to gain a comprehensive understanding of the intricate relationship between negative psychological health attributes and diminished CVH (Levine et al, 2021).

To facilitate convenience in clinical or research environments, the American Heart Association (AHA) has organized the newly introduced CVH definition, comprising the "Life's Essential 8 (LE8)" metrics, into two distinct domains: health behaviors (diet, physical activity, tobacco/nicotine exposure, and sleep health) and health factors (body mass index (BMI), non-high-density-lipoprotein (HDL) cholesterol, blood glucose, and blood pressure).

The objective of this study was to examine the association between LE8 scores and depression in United States adults, taking into account the role of CVH. The analysis utilized data from the National Health and Nutrition Examination Survey (NHANES).