Heart Health ‘The 8 Essentials of Life’


THURSDAY June 30, 2022

Good sleep is essential, and a widely used scoring system for heart and brain health is being redefined to reflect this.

Since 2010, the American Heart Association has declared that seven modifiable elements – maintaining a healthy weight, not smoking, being physically active, eating a healthy diet, and controlling blood pressure, cholesterol and blood sugar – are essential for cardiovascular health. ideal.

These components, dubbed Life’s Simple 7, have become a common way for doctors and patients to assess and discuss heart and brain health. It is also a key research tool, used in more than 2,500 scientific articles.

Sleep duration joins those original seven measures in a revised scoring tool, now called Life’s Essential 8, which was published Wednesday as the AHA’s presidential advisory in the journal Circulation.

The update is about much more than adding sleep, said AHA President Dr. Donald Lloyd-Jones, who led the expert panel that wrote the advisory. The new score incorporates 12 years of research and improves its assessment of diet, exercise and more.

“We hope this will be, in fact, a time of empowerment, a time of optimism for people to think positively about their health,” said Lloyd-Jones, cardiologist, epidemiologist and chair of preventive medicine at Northwestern University Feinberg. Chicago School of Medicine. “And that’s a good way for them to measure it today, monitor it over time, and focus on ways to maintain it and improve it.”

Adults should average seven to nine hours of sleep per night, the advisory says. For children, the amount varies according to age.

Lloyd-Jones, who led the creation of the original seven categories in 2010, said the importance of sleep was already clear then. But it was difficult to agree on how to score it, because sleep information was not collected in large national databases.

“It is now,” he said, and “science has shown us how integral sleep is to cardiovascular health.”

The advisory notes that too much and too little sleep are associated with heart disease and that poor sleep health is linked to poor psychological health, an important contributor to heart disease.

“And of course sleep also affects the other seven metrics here,” Lloyd-Jones said.

Cheryl Anderson, dean of the Herbert Wertheim School of Public Health and Human Longevity Science at the University of California, San Diego, called Life’s Essential 8 a “big deal” for both medical professionals and people who want to understand their cardiovascular health.

Anderson, who co-wrote the advisory, said the update is “a very good recognition of how the science has changed and our ability to adapt to the changes.”

The revisions introduce a 100-point measure of heart health, which can be viewed online at www.heart.org/lifes8.

The new score replaces a 14-point scale and changes several of the original categories.

Regarding smoking, for example, the old measure only took into account the traditional use of cigarettes. The new score includes nicotine consumption and exposure to electronic cigarettes, as well as the effects of secondary exposure.

The new score also shifts from a focus on total cholesterol to measuring non-HDL cholesterol. It is now calculated by subtracting “good” HDL cholesterol from total cholesterol, leaving only a measure of “bad” cholesterol types. The new tool also expands the way blood sugar can be assessed.

The system allows for more accurate assessment of exercise levels, Lloyd-Jones said. And he looks at the regime in a new way. “Before, we had five very clunky yes-or-no measures to tell whether someone had a healthy diet or not. And that wasn’t really appropriate for all different kinds of eating habits and cultures.”


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Anderson said the new diet component measures how well a person follows a Dietary Approaches to Stop Hypertension, or DASH, type diet.

But while the measure expands the foods assessed, people shouldn’t focus on single items, Anderson said. “We want to think about the whole package. There is no single food or nutrient that will completely overhaul a person’s cardiovascular health.”

Some key elements of heart health, such as stress, are not part of the new score.

“The stress is real,” Lloyd-Jones said. “It’s an important part of all of our lives. But it’s hard to measure how we internalize this stress and what effect it has on our health.”

The advisory discusses the importance of psychological health and societal and environmental factors known as the social determinants of health, which include access to healthy food, medical care or a safe place to do some exercice. But although Lloyd-Jones called them “fundamental” to heart health, he said those factors couldn’t be summed up in something that matched the scoring system.

The old grading system sorted responses into its seven categories as ‘poor’, ‘intermediate’ or ‘ideal’. Less than 1% of people in the United States across all age groups have reached the overall “ideal” level, primarily due to their diet, the advisory says.

But for people who want to improve their heart health, the new approach makes progress easier to see. “Positive changes don’t have to be really big,” Anderson said. “They can be moderated. And you can still get credit for that under this new approach.”

Good heart health starts with talking with a doctor to find out how you’re doing in all eight categories, Lloyd-Jones said. Improving one of them helps.

“If I have three or four things out of the eight that are not optimal that I could work on, should I tackle three or four at once? Absolutely not,” he said. “The data shows us that choosing and improving one thing will actually have a measurable impact on improving your health and improving your health outcomes.”

So people shouldn’t feel overwhelmed, he said. “It doesn’t matter which one you choose. Pick the one you’re going to be successful at. And that’s how you’ll advance your cardiovascular health.”

American Heart Association News covers heart and brain health. Any opinions expressed in this story do not reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have any questions or comments about this story, please email [email protected].

By Michael Merschel, American Heart Association News

By American Heart Association News HealthDay Reporter

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