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OBJECTIVES: Poor cardiovascular health (CVH) and the high prevalence of depressive symptoms represent significant public health concerns, underscoring the importance of examining their association. This study aimed to investigate the association between CVH, as defined by the American Heart Association's 2022 Life's Essential 8 (LE8) framework, and depressive symptoms.METHODS: This study used data from the 2014, 2016, 2018, and 2020 Korea National Health and Nutrition Examination Survey. Overall CVH, measured using LE8, was categorized into 3 groups: low score (0-<50), moderate score (50-<80), and high score (80-100). LE8 comprises 2 subdomains: health behaviors and health factors. Depressive symptoms were defined as a total score ≥10 on the Patient Health Questionnaire-9. Multiple logistic regression analyses were performed, adjusting for sex, age, socioeconomic status, and current drinking status.RESULTS: Among 17,294 adults, 257 men and 681 women reported significant depressive symptoms. Compared with individuals in the low LE8 category (reference), the odds ratio (OR) for depressive symptoms was 0.29 (95% CI: 0.21-0.40) for those in the high LE8 category. The OR for depressive symptoms was 0.39 (95% CI: 0.29-0.53) for individuals with a high health behavior score compared with those with a low health behavior score. In contrast, the health factor score was not significantly associated with depressive symptoms.CONCLUSION: These findings suggest that overall CVH, particularly the health behavior subdomain, was associated with lower odds of depressive symptoms. Prospective longitudinal studies are warranted to validate these findings and clarify the directionality of the observed associations.