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Are You Heart Healthy? This Checklist May Have the Answer

American Heart Association checklist now includes 8 key components of cardiovascular health

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Courtesy Malte Mueller

If you are like most Americans, there is room for improvement when it comes to lowering your risk for heart disease.

Cardiovascular disease is the number 1 cause of death in the U.S., according to the American Heart Association, which has updated its checklist of essential components for ideal heart and brain health, adding a good night’s sleep to the mix, among other changes.

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Using the updated checklist to score cardiovascular health for more than 23,400 adults and children, the AHA found the overall cardiovascular health of Americans is “well below ideal.” The results appear in the AHA journal Circulation. In fact, about 80 percent of the 13,500 adults (ages 20­ to 79) included in the study scored at a low or moderate level.

The study measured cardiovascular health on a scale of 0 to 100, creating three ranges: “low” for scores below 50, “moderate” for scores from 50 to 79, and “high” cardiovascular health for scores 80 and above.

Just 19.6 percent of adults in the U.S. have “high” cardiovascular health, 62.5 percent scored “moderate,” and 17.9 percent were “low,” the study found.

Various research studies over the past two decades indicate more than 80 percent of all cardiovascular events may be prevented by healthy lifestyle and management of known cardiovascular risk factors, according to the AHA. So, it’s important to know what you can do to lower your risk.

“The idea of optimal cardiovascular health is important because it gives people positive goals to work toward at any stage of life,” AHA President Donald M. Lloyd-Jones, M.D., who led the study and chairs the department of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago, said in a statement.


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The AHA Checklist

The AHA checklist first identified seven metrics for cardiovascular health in 2010. The latest update — now up to eight factors — is guided by more than a decade of scientific research. It also attempts to do a better job of discerning racial, ethnic and other demographic differences in heart health.

1. Diet: Score higher by eating more fruit, vegetables, whole grains, low-fat dairy, nuts and legumes and consuming less red or processed meat, sweetened drinks and salt.

2. Physical activity: The optimal level is 150 minutes of moderate physical activity or more per week or 75 minutes per week of vigorous-intensity physical activity, as defined by the U.S. Physical Activity Guidelines for Americans. Only 1 in 4 Americans report achieving the optimal level of physical activity, according to the AHA.

3. Nicotine exposure: Don’t smoke. That includes e-cigarettes or vaping.

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4. Sleep: Ideally, you should average 7 to 9 hours nightly. “The new metric of sleep duration reflects the latest research findings: Sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure or risk for Type 2 diabetes more effectively,” said Lloyd-Jones.

5. Body mass index: Although it is considered an imperfect measure, a BMI between 18.5 and 24.9 is associated with the highest levels of cardiovascular health. However, research suggests the range may differ depending on race or ethnicity. About 100 million Americans are considered obese, according to the AHA.

6. Blood lipids (cholesterol): When it comes to cholesterol and triglycerides, focus on non-HDL cholesterol numbers that, when high, are linked to cardiovascular disease risk. They can also be measured without fasting beforehand.

7. Blood glucose (sugar): The metric has been expanded to include the option of hemoglobin A1c readings, a key measure to assess type 2 diabetes risk. The AHA notes that more than 28 million Americans have type 2 diabetes.

8. Blood pressure: Shoot for blood pressure levels that are less than 120/80 mm Hg (the optimal range). Hypertension is defined as 130–139 mm Hg systolic pressure (the top number in a reading) or 80–89 mm Hg diastolic pressure (bottom number). Approximately 121.5 million people in the U.S. have high blood pressure, according to the AHA.

In general, U.S. adults scored lowest in the areas of diet, physical activity and BMI. Scores were generally lower at older ages. Asian Americans, on average, scored better than other racial and ethnic groups, followed by non-Hispanic whites, Hispanics, Mexicans and Blacks, according to the AHA. 

Peter Urban is a contributing writer and editor who focuses on health news. His freelance work has appeared in Scientific American, Bloomberg Government, and

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