On June 29, the American Heart Association announced that it had updated its cardiovascular health checklist — also known as the Life’s Simple 7 — for the first time since it released the checklist in 2010. The new checklist includes sleep as a new and 8th marker of cardiovascular health, as well as adding crucial updates to other checklist items. Now Life’s Simple 7 are the Life’s Essential 8.
The new, eighth component — sleep duration — is officially considered an “essential component for ideal heart and brain health.” Other updates include that the cardiovascular checklist applies to anyone 2-years-old and older, includes a new diet guide, accounts for exposure to secondhand smoke and vaping, and updates cholesterol and blood sugar measurements.
“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 American Heart Association President Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, who led the advisory writing group, in a statement. “In addition, advances in ways to measure sleep, such as with wearable devices, now offer people the ability to reliably and routinely monitor their sleep habits at home.”
The checklist is very important to Americans’ health as heart disease is the number one cause of death in the United States and worldwide, and 80% of all heart-related events are preventable with healthy lifestyle choices.
The new checklist includes:
The updated checklist includes a new guide to “assess diet quality for adults and children at the individual level” and population level. For individuals, the “Mediterranean Eating Pattern for Americans (MEPA) is used to assess and monitor cardiovascular health. There are 16 yes or no questions about how often patients eat olive oil, veggies, berries, meats, fish, and more.” At the population level, the DASH diet (Dietary Approaches to Stop Hypertension) will be considered, which includes the following components: high intake of fruits, vegetables, nuts and legumes, whole grains, low-fat dairy, and low intake of sodium, red and processed meats, and sweetened drinks.
This guideline is the same as it was in 2010: The American Heart Association still recommends at least 150 minutes of moderate physical activity a week or 75 minutes of intense physical activity for adults. For kids 6 and up, 420 minutes of physical activity is recommended.
In the 2010 checklist, only traditional cigarettes were mentioned. Now, vapes are added to the checklist — and long-term use of either affects health. Second-hand smoke exposure for kids and adults is now also included in the checklist.
For the first time ever, sleep duration has been officially linked to cardiovascular health on this checklist. Adults should get 7-9 hours a night, 13 to 18-year-old need 8-10 hours, kids aged 6 to 12 need 9-12 hours, and 1those age 5 and younger need 10-16 hours of sleep.
Although “the writing group acknowledges that the BMI is an imperfect metric…it is easily calculated and widely available; therefore, BMI continues as a reasonable gauge to assess weight categories that lead to health problems.” A BMI of 18.5 to 24.9 is associated with “the highest levels of cardiovascular health.” The impact or significance of your BMI measurement will differ depending on your racial or ethnic background.
Instead of measuring total cholesterol, the experts now recommend that doctors measure non-HDL cholesterol (HDL cholesterol is known as the “good” cholesterol). This is because patients do not need to fast to have their non-HDL cholesterol measured, making it easier to measure and easier to implement, and more reliably calculated. High levels of non-HDL cholesterol are linked to risk for cardiovascular disease.
Blood sugar levels are linked to diabetes. Now, doctors can use a specific type of test, called hemoglobin A1c readings, for people with or without diabetes or prediabetes. That’s because hemoglobin A1c “can better reflect long-term glycemic control.”
There are no changes to blood pressure recommendations from 2017 guidelines from the American Heart Association, which says that 120/80 is optimal and 130-139/80-89 is defined as hypertension.
Answers to the eight-point checklist can be scored on a scale of 0 to 100 points total. Anything below 50 reflects poor cardiovascular health, scores between 50-79 are moderate, and anything between 80-100 represents good health. You should go through the checklist every 5 years.
As for what’s next? The AHA is looking at more data about “the impacts of stress, mental health, and social determinants of health” in order to potentially update the checklist in the future.