Life’s Essential 8: The Scorecard for Your Heart

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In 2022, the American Heart Association (AHA) updated its earlier guidelines (called Life’s Simple 7) and expanded it into Life’s Essential 8. These eight key measures provide a comprehensive look at factors that influence your heart and overall health:

• Eating a healthy diet
• Being physically active
• Avoiding nicotine
• Getting good sleep
• Maintaining a healthy weight
• Managing blood lipids (cholesterol and other fats in the blood)
• Managing blood glucose (blood sugar levels)
• Keeping blood pressure in a healthy range

“It’s natural that as you age your health may start to decline, particularly as you develop conditions such as high blood pressure or have major cardiovascular events like a stroke,” Stacey Rosen, M.D., volunteer president of the AHA and senior vice president of women’s health and executive director of the Katz Institute for Women’s Health of Northwell Health, said in a statement. “That’s why the AHA urges everyone to get their best start at good health by following the elements of Life’s Essential 8 early in life, even as young as childhood.”¹

When people do well across all eight areas, research shows they live longer, feel better and are less likely to develop cardiovascular disease.

Investigators looked at national health survey data collected from 2013 to 2018. The study included more than 3,000 adults aged 65 and older, representing nearly 38 million people in the United States. Participants reported whether they had any cardiovascular conditions, such as high blood pressure, heart failure, coronary artery disease, chest pain, stroke or heart attack.

Each person’s heart health was scored based on the eight categories, with points ranging from 0 to 100 for each. The scores were then averaged:

• 80 or higher = high cardiovascular health
• 50-79 = moderate cardiovascular health
• Below 50 = low cardiovascular health

On average, older adults without cardiovascular disease had a heart health score of about 68 out of 100, putting them in the moderate range. Those who reported having at least one heart condition had significantly lower scores — falling below 60 on average.

Importantly, the more conditions a person had, the lower their score tended to be. For example, people with high blood pressure, heart failure or a past stroke saw the steepest declines. Between 2013 and 2018, the study found the following:

• Adults with high blood pressure had a 4.1% drop in scores.
• Adults with a history of stroke had an 11.5% drop.
• Adults with heart failure had a 15.2% drop.

Researchers believe much of this gap comes from lower scores in blood pressure control and physical activity levels among people with heart disease.

The study highlights how important it is to pay attention to the full picture of your heart health — not just one or two numbers. Even small changes in lifestyle can help improve your score on the Life’s Essential 8. For example:

• Adding more fruits, vegetables and whole grains to your meals can boost your diet score.
• Regular physical activity, even light walking or stretching, can improve both weight and blood pressure.
• Prioritizing quality sleep supports heart function and helps manage blood sugar.
• If you smoke, quitting is one of the most powerful steps you can take to protect your heart.

While some factors like a history of stroke or heart failure cannot be changed, many of the Life’s Essential 8 measures are within your control. Focusing on what you can change may help slow down or prevent further decline in heart health.

“We must identify ways to support these older individuals with information and resources to maintain a healthy lifestyle in every way they can, because good health is important at every age," concluded Rosen.