CARDIOVASCULAR health among older adults living with cardiovascular disease (CVD) in the United States has shown troubling declines in recent years, according to new data from the National Health and Nutrition Examination Survey (NHANES) spanning 2013 to 2018. Using the American Heart Association’s Life’s Essential 8 (LE8) scoring system, researchers found that seniors with hypertension, stroke, and heart failure experienced significant deterioration in their cardiovascular health metrics.
The study analyzed 3,050 adults aged 65 years and older, representing more than 37 million U.S. seniors, with a mean age of 72.6 years. Participants self-reported diagnoses of coronary heart disease, stroke, heart failure, hypertension, angina, or myocardial infarction. LE8 scores, ranging from 0 to 100, assessed overall cardiovascular health, with higher scores reflecting better outcomes.
Results revealed stability or modest declines in cardiovascular health across the general older population. However, the most pronounced decreases occurred in groups already living with CVD. Participants with hypertension showed a 4.1% decline in mean LE8 scores, falling from 59.6 to 57.1 (P<0.01). Those with stroke experienced an 11.5% decline, from 60.6 to 53.6 (P=0.01), while individuals with heart failure demonstrated the steepest drop—a 15.2% reduction from 60.9 to 51.6 (P<0.001). These declines underscore critical concerns for clinicians, as the LE8 framework includes both behavioral and physiologic measures tied to cardiovascular risk, such as diet, physical activity, cholesterol, blood pressure, and glucose. The findings highlight missed opportunities in both primary and secondary prevention for older adults already at the highest risk for recurrent or new cardiovascular events. Importantly, the data predate the COVID-19 pandemic, suggesting that health system disruptions during the pandemic may have further exacerbated these declines. For U.S. clinicians, the study reinforces the urgency of proactive management strategies aimed at improving cardiovascular health metrics in high-risk older populations. Reference: Walker JM et al. Comparing the “Life's Essential 8” Scores of Older Adults Living With Cardiovascular Diseases: NHANES, 2013 to 2018. J Am Heart Assoc. 2025. doi:10.1161/JAHA.124.039659
