Getting to the Heart of the Matter: Study Reveals Only 20% of Americans Have Optimal Heart Health

In the United States, cardiovascular disease (CVD) continues to be the leading cause of mortality for both men and women, as well as individuals of most racial and ethnic groups. CVD also accounts for an estimated 1 in every 4 deaths.¹  

While clinical data reveals that preventive measures such as diet, exercise, weight loss, and getting sufficient sleep can be effective in reducing and thwarting the incidence of CVD, a recent study conducted by the American Heart Association (AHA) reveals some concerning findings about cardiovascular health among Americans.

According to a recent study² published in Circulation, approximately 80% of individuals in the United States have low- to moderate-quality cardiovascular health, based on the AHA’s Life’s Essential 8.³

Life’s Essential 8, which was also recently published in Circulation, includes measures for enhancing and maintaining cardiovascular health. According to a press release⁴ by the AHA, “Life’s Essential 8 is more sensitive to differences in cardiovascular health among groups of people and individuals compared to the previous 7-item scoring system that did not include sleep duration.”  

Included elements are diet, physical activity, nicotine exposure, sleep health, weight, cholesterol, blood glucose, and blood pressure. Each metric is scored from 0 to 100 points, which clinicians can use to generate a composite score between 0 and 100, indicating low (≤50), moderate (50-79), or high (≥80) cardiovascular health.^3-4 

In this study, Life’s Essential 8 scoring was calculated using data from the US National Health and Nutrition Examination surveys spanning 2013-2018. The study included approximately 13,500 participants aged 20-79 years and 9900 participants aged 2 to 19 years, all free of CVD.⁴

The average Life’s Essential 8 score was 64.7 and 65.5 for US adults and children, respectively. Findings showed only 19.6% of surveyed adults had scores in the high health range, and fewer than 1% scored 100. Meanwhile, 62.5% of adults had moderate cardiovascular health, and 17.9% had low health.

Women had higher scores on average compared to men (67 vs 62.5). Non-Hispanic Asian Americans and non-Hispanic Black Americans had the highest and lowest average scores, respectively.

Children’s diet scores were low, and adults’ diet, fitness, and body mass index scores were the lowest metrics.

The researchers concluded the new Life's Essential 8 score is a useful measure of cardiovascular health across groups, and there are opportunities to address suboptimal heart health in the United States. By improving cardiovascular health across the US population, there is potential to majorly enhance quality of life and health longevity.²

In the press release,⁴ Donald M Lloyd-Jones, MD, ScM, FAHA, lead investigator, president of AHA, and chair, department of preventive medicine, Northwestern University’s Feinberg School of Medicine in Chicago, stated:

“These data represent the first look at the cardiovascular health of the US population using the AHA's new Life’s Essential 8 scoring algorithm. Overall, the cardiovascular health of the US population is suboptimal, and we see important differences across age and sociodemographic groups. Analyses like this can help policy makers, communities, clinicians, and the public to understand the opportunities to intervene to improve and maintain optimal cardiovascular health across the life course.”

Conclusion

The data from this study is concerning and should be a wake-up call for clinicians to expand awareness about the factors behind promoting and maintaining cardiovascular health. Since various sources indicate cardiovascular disease is 85 to 90% preventable,⁵ it is imperative that the health care system increase efforts to highlight the essential value of preventive measures such as routine health care and healthier lifestyle measures, including weight loss, smoking cessation, eating a healthy balanced diet, obtaining an adequate amount of sleep, and exercise.

Clinicians should also encourage patients to understand their modifiable and nonmodifiable risk factors for CVD and take an active role in their health. Through patient education, early identification, and clinical intervention, the number of Americans attaining optimal cardiovascular health could grow.

More information on Life's Essential 8 can be found at https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8.

References:

1. Centers for Disease Control and Prevention. Heart disease facts. Centers for Disease Control and Prevention. Updated February 7, 2022. Accessed July 14, 2022. https://www.cdc.gov/heartdisease/facts.htm
2. Lloyd-Jones DM, Ning H, Labarthe D, et al. Status of cardiovascular health in US adults and children using the American Heart Association's new "Life's Essential 8" metrics: prevalence estimates from the National Health and Nutrition Examination Survey (NHANES), 2013-2018. Circulation. Published online June 29, 2022. doi:10.1161/CIRCULATIONAHA.122.060911
3. Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life's Essential 8: updating and enhancing the American Heart Association's construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. Published online June 29, 2022. doi:10.1161/CIR.0000000000001078
4. Only 1 in 5 people in the US has optimal heart health. News release. American Heart Association; June 29, 2022. Accessed July 14, 2022. https://newsroom.heart.org/news/only-1-in-5-people-in-the-u-s-has-optimal-heart-health?preview=803c
5. Ninety percent of heart disease is preventable through healthier diet, regular exercise, and not smoking. News release. Cleveland Clinic; September 29, 2021. Accessed July 14, 2022. https://newsroom.clevelandclinic.org/2021/09/29/90-percent-of-heart-disease-is-preventable-through-healthier-diet-regular-exercise-and-not-smoking/