IN 2010, the American Heart Association (AHA) introduced a new framework to define and promote cardiovascular health (CVH), marking a major shift in preventive cardiology. This model, centred on ‘Life’s Simple 7’ (LS7), identified seven core health behaviours and factors: diet, physical activity, smoking status, body mass index, blood pressure, cholesterol, and glucose levels. Unlike previous risk-based approaches, LS7 proactively encouraged lifelong CVH, including values below traditional clinical thresholds.
Over the past decade, a wealth of research has validated the importance of LS7, linking higher CVH scores to lower risks of cardiovascular disease (CVD), all-cause mortality, and even non-cardiovascular conditions such as cognitive decline and peripheral artery disease. Evidence shows that optimal CVH not only supports physical health, but also boosts mental well-being, reduces healthcare costs, and promotes intergenerational health benefits. For instance, maternal CVH during pregnancy has been found to influence adolescent offspring’s health outcomes.
Despite its benefits, the global prevalence of optimal CVH remains alarmingly low, particularly from middle age onward, and is notably worse among socially disadvantaged groups. Encouragingly, community-based interventions, such as programmes in Black churches and underserved rural areas, have shown that CVH can be improved through targeted, culturally appropriate strategies.
In 2022, the AHA introduced an updated framework, ‘Life’s Essential 8’ (LE8), which includes sleep as an eighth metric and expands the definition of nicotine exposure. LE8 offers a more refined scoring system, especially useful for assessing CVH in children and detecting small but meaningful improvements.
Looking ahead, future research must prioritise CVH equity by focusing on underrepresented populations and considering the influence of environmental threats like pollution and endocrine-disrupting chemicals. The first decade of CVH research has laid a robust foundation, and with continued commitment, this proactive approach holds the promise of healthier, longer lives for people across the globe.
Reference
Aguayo L et al. Cardiovascular health, 2010 to 2020: a systematic review of a decade of research on life’s simple 7. J Am Heart Assoc. 2025;DOI:10.1161/JAHA.124.038566.
