IS YOUR HEART HEALTH AS GOOD AS YOU THINK? ONLY ONE IN FIVE AMERICA ADULTS HAS OPTIMAL heart health. Approximately 80 percent of the United States have low to moderate cardiovascular health.

Today we explore the American Heart Association eight-point checklist for optimal heart health. Historically we had seven items on the heart-healthy list, but adequate the AHA recently added adequate sleep.

The American Heart Association also redefined four original metrics for consistency with newer clinical guidelines (or compatibility with new measurement tools). The scoring system now applies to anyone at least two years of age.

Heart health checklist

The American Heart Association (AHA) first defined the seven measures for optimal cardiovascular health in 2010. It recently updated the list of metricsbased on over 2,400 subsequent scientific papers addressing the topic.

Here is a snapshot of the eight metrics deemed “Life’s Essential 8 metrics” by the researchers.

• Diet. At the population level, diet assessment is based on daily intake of elements in the Dietary Approaches to Stop Hypertension (DASH) eating pattern. For individuals, the AHA uses the Mediterranean Eating Pattern for Americans (MEPA) to assess and monitor cardiovascular health.
• Physical activity. The optimal level is 2.5 hours of moderate physical activity or more per week or 75 minutes per week of vigorous-intensity physical activity for adults.

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• Nicotine exposure. Added to the previous metric (of not smoking traditional cigarettes) is avoidance of the use of inhaled nicotine-delivery systems (for example, e-cigarettes or vaping devices). The AHA also added avoidance of second-hand smoke exposure.
• Sleep. Duration of sleep is associated with cardiovascular health. The ideal is an average of seven to nine hours daily for adults. Those 13 to 18 should aim for eight to ten hours of sleep.

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• Body mass index. The AHA acknowledges that body mass index (BMI) is an imperfect metric. However, as we can easily calculate BMI, the AHA views it as a reasonable metric. A BMI of 18.5–24.9 is associated with the highest levels of cardiovascular health. There is some variability by race. For example, people of Asian or Pacific Islander ancestry have a higher risk of conditions such as cardiovascular disease or type 2 diabetes at a lower BMI than other races.
• Blood lipids. Non-HDL cholesterol is the preferred number to monitor (rather than total cholesterol). Non-HDL cholesterol can be measured without fasting and is reliable for all.
• Blood glucose. The metric has expanded to include the option of hemoglobin A1c readings or blood glucose (sugar) levels for people with or without type 1 or 2 diabetes or pre-diabetes.
• Blood pressure. Less than 120/80 mm Hg is optimal, with high blood pressure (hypertension) defined as 130–139 mm Hg systolic pressure or 80–89 mm Hg diastolic pressure.

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Heart health of US population concerning

Using Life’s Essential 8 from above shows the cardiovascular health of those in the United States to be concerning, with 80 percent of adults scoring at a low or moderate level.

Data for the analysis came from 2013–2018 US National Health and Nutrition Examination surveys (NHANES) of over 13,500 adults, ages 20–79 years, and nearly 9900 children, ages 2–19 years.

Let’s look in more detail at the study results. On a scale of 0 to 100 for cardiovascular health, adults and children scored 65. Less than one in 200 had a perfect score of 100, 20 percent had high cardiovascular health (score of at least 80), 63 percent moderate (score of 50 to 79), and 18 percent had low cardiovascular health (score of less than 50).

Women did better than men, with average cardiovascular health scores of 67 and 63, respectively. Adults overall scored lowest in diet, physical activity, and body mass index (BMI).

In general, age mattered, with cardiovascular health scores declining with age. Note that children had low diet scores, at an average of only 41.

Asian Americans had the highest scores, followed by whites, non-Mexican Hispanics, Mexican-Americans, and non-Hispanic Blacks.

Heart health in America — My take

Life’s Essential 8 lets us identify when our heart health is suboptimal. I hope the list energizes all of us to improve cardiovascular health (at every life stage). On which of the metrics can you do better?

Finally, I should note that the research cited had no commercial funding, and the study authors reported no relevant financial relationships. Thank you for joining me today in this look at your heart health and “Life’s Essential 8 Metrics.”

The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.