Today the American Heart Association (AHA) unveiled "Life's Essential 8," the association's updated and enhanced construct of cardiovascular health (CVH) developed to take the place of 2010's "Life's Simple 7" as a means to define and quantify CVH in the US.
Scoring for the new model found that only 1 in 5 people in the US has optimal CVH with scores differing significantly according to age, gender, race/ethnicity, income level, and depression statuts. According to the AHA, LIfe's Essential 8 is more sensitive than Life's Simple 7 to differences in CV health across diverse populations.
The AHA conceived of the original Life's Simple 7 in response to decades of decline in CV death rates to expand its focus beyond addressing CV health as merely the absence of disease to incorporating strategies that would more directly and actively promote individual and population health as well. The experience with the construct since 2010 led to the enhanced quantification methods and additional metrics (sleep duration was added) included in the updated the LIfe's Essential 8 approach to measuring, monitoring, and modifying CVH.
In the following short slide show we offer an at-a-glance review of the 8 essential health domains—diet, physical activity, nicotine exposure, sleep health (new), body mass index, blood lipids, blood glucose, and blood pressure—whether they have been updated, and if so, how.
Life's Essential 8 - #1. Diet for the individual. Updated: The Mediterranean Eating Pattern for Americans (MEPA) is used to assess and monitor CV health. The DASH-style eating pattern can be measured with 16 yes or no questions about the weekly frequency of eating olive oil, vegetables, berries, meat, fish, dairy, grains, etc.
Life's Essential 8 - #1. Diet for populations. Updated: Dietary assessment is based on daily intake of elements in the Dietary Approaches to Stop Hypertension (DASH) eating pattern.
Life's Essential 8 - #2. Physical activity. No change: Adults advised to engage in 150 mins of moderate or 75 mins of vigorous PA/week.
Life's Essential 8 - #3. Nicotine exposure. Updated: Use of inhaled nicotine-delivery systems, which includes e-cigarettes or vaping devices, is added since the previous metric only monitored traditional, combustible cigarettes.
Life's Essential 8 - #4. Sleep duration. New: Sleep duration has been added as a component of cardiovascular health. Inappropriate duration, either too much or too little, has been linked with coronary heart disease.
Life's Essential 8 - #5. Body mass index. No change: BMI remains a reasonable gauge to assess weight categories that may be injuriuos. BMI of 18.5–24.9 kg/m2 is associated with the highest levels of cardiovascular health.
Life's Essential 8 - #5. BMI range adjustments. No change: BMI ranges and associated health risks may differ among racial/ethnic backgrounds and so require adjustment up or down as evidence becomes available.
Life's Essential 8 - #6. Blood lipids. Updated: Non-HDL-C is now the preferred value to monitor given it can be measured in the nonfasting state and reliably calculated among all people.
Life's Essential 8 - #7. Blood glucose. Updated: The metric is expanded to include HbA1c measurement in addition to FPG to better reflect glycemic control in persons with diabetes.
Life's Essential 8 - #8. Blood pressure: No change: Criteria remain the same and are based on levels established by AHA in 2017 -- Optimal <120/80 mm Hg and hypertension 130-139 mm Hg systolic or 80-89 mm Hg diastolic pressure.
Life's Essential 8 Assessment. Scoring updated: Each of the 8 health measures is scored on a scale of 0 to 100. The average of those scores reflects an individual's overall CV health score, as above.
Life's Essential 8: Stress, mental health, social determinants of health. The AHA committee considered the topics carefully and determined more research is needed on these components to establish their measurement and inclusion in the future.
Reference: Lloyd-Jones DM, Allen NB, Anderson CAM, et al, on behalf of the American Heart Association. 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 ahead of print June 29, 2022. doi: 10.1161/CIRCULATIONAHA.122.060911