Abdominal aortic calcification (AAC) represents a manifestation of vascular calcification, appearing in all artery wall layers [1,2]. The incidence and severity of AAC escalate with advancing age among US women [3]. Mounting evidence has indicated that arterial calcifications are pivotal in augmenting cardiovascular risk [4,5]. Cardiovascular disease (CVD) can now be predicted independently by employing AAC [6]. This straightforward and cost-effective assessment offers a potentially beneficial instrument for CVD management [6]. Vascular calcification stands as a significant contributor to the elevated prevalence and mortality rates of CVD and cerebrovascular diseases [[6], [7], [8], [9]]. Furthermore, AAC has also been identified as being related to myocardial infarction [10], incident coronary heart disease [11], and stroke [12]. Nevertheless, there is presently no efficacious treatment for AAC [13]. Consequently, it holds profound importance to investigate the risk factors and proactively prevent the onset of AAC.

Cardiovascular health (CVH) was introduced by the American Heart Association (AHA) in 2010, encompassing a combination of lifestyle factors and biological measures [14]. The initial assessment of CVH was founded upon seven health behaviors called Life's Simple 7 (LS7) [15]. Life's Essential 8 (LE8), which consists of four health behaviors (diet, physical activity, nicotine exposure, and sleep duration) and four health factors (body mass index (BMI), blood lipid, blood glucose, and blood pressure), has recently been adopted as the AHA's updated definition of ideal CVH metrics [15,16]. The significant enhancement in LE8 is the addition of sleep quality, as evaluated by sleep duration, and the updating of the scoring algorithm. A higher overall score corresponded to improved CVH in LS7 and LE8 [17].

Advanced age, osteoporosis, and chronic kidney disease were considered the foremost risk factors for AAC [18]. Numerous studies have unequivocally established a correlation between AAC and diverse cardiovascular incidents [19]. Nevertheless, the connection between CVH indicators and AAC remains a topic of unclear. With LE8 recently emerging as the latest metric for assessing CVH, this study aimed to look into the intricate relationship between CVH, defined by the LE8 score, and AAC.