Background <p>Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are intimately connected. A recently developed measure called Life’s Essential 8 (LE8) is used to evaluate cardiovascular health (CVH). We aimed to investigate the relationship between LE8 and the prevalence of COPD, and the association between LE8 and all-cause mortality in individuals with COPD.</p> Methods <p>The National Health and Nutrition Examination Survey (NHANES) 2005–2018 was the source of the data used in our investigation. The participants were divided into three groups according to their LE8 scores: low (&lt; 50), moderate (50–79), and high (≥ 80) CVH. Weighted logistic regression models and restricted cubic spline (RCS) curves were used to examine the relationship between LE8 score and the prevalence of COPD. To determine whether the results were stable, we used subgroup and sensitivity analyses. Furthermore, we evaluated the association between LE8 and all-cause mortality in COPD patients using a weighted Cox regression analysis.</p> Results <p>Weighted logistic regression analysis of the fully adjusted model indicated that a higher LE8 score was associated with a lower prevalence of COPD (OR = 0.75; 95% CI, 0.71–0.79). The RCS curves showed a linear negative association between them. LE8 score was negatively correlated with the prevalence of COPD across all subgroups, and this negative correlation was significant in those younger than 60 years old. The sensitivity analysis’s results were consistent with the primary findings. Furthermore, weighted Cox regression analysis of the fully adjusted model showed that LE8 score was negatively associated with all-cause mortality in COPD patients (HR = 0.81, 95% CI = 0.74–0.89).</p> Conclusions <p>LE8 score was negatively associated not only with the prevalence of COPD, but also with all-cause mortality in patients with COPD.</p> Clinical trial number <p>Not applicable.</p>