The American Heart Association’s Essential 8™ provides an excellent checklist for improving cardiovascular health and reducing the principal risk factors for cardiovascular disease, heart attack, cardiac arrest, and stroke.
Originally developed in 2010 as “Life’s Simple 7,” the American Heart Association’s construct has been updated to “Life’s Essential 8.” The updated construct includes sleep guidelines and new advice for some of the other seven health factors that can be applied throughout a person’s entire life course, starting from birth.
At AED Leader, we fully support all actions that Americans can take to improve their heart health and reduce their risk of cardiovascular events. Combined with emergency preparedness, taking preventative action by applying the AHA Essential 8 could significantly boost Americans’ quality of life while preventing tens or even hundreds of thousands of untimely deaths in the United States each year.
1. Healthy Diet
Eating a healthy diet is the first and most powerful thing you can do to improve cardiovascular health. Work toward an overall healthy eating pattern that focuses on:
- Whole foods
- Plenty of fruits and vegetables
- Lean protein from animal and plant sources
- Nuts and seeds
- Non-tropical oils like olive oil
To improve your diet:
- Swap highly processed foods for whole-food alternatives. Simple switches can make a huge difference over time. For example, you could snack on lightly-roasted nuts and avocado instead of deep-fried chips, and veggie sticks and hummus instead of chocolate.
- Set aside time to cook at home rather than buy take-out. There are lots of heart-healthy recipe ideas on the AHA website. If you’re pressed for time, it often helps to cook in larger batches or, at a minimum, chop and freeze vegetables on the weekend ready to add to your meals throughout the week.
- Focus on progress, not perfection. It takes time to learn new recipes and get used to the taste of whole foods, especially considering that packaged foods are typically high in sugar, salt, and flavorings. Celebrate every achievement and don’t worry if you slip up every now and again. Just get back on track as soon as you can and plan ahead so that you’re prepared with healthier options next time.
2. Physical Activity
Together with diet quality, regular physical activity is one of the best things you can do for your heart health as well as your psychological health. The Centers for Disease Control and Prevention (CDC) recommends that all adults aim for a minimum of:
- 150 minutes of moderate physical activity, like dancing or water aerobics, every week, OR
- 75 minutes of vigorous physical activity, like running or swimming laps, every week, OR
- A combination of the two
- Two sessions of strength training per week, using weights or your own body weight
Children and teens should get at least 60 minutes of exercise per day, including a mixture of unstructured play and more structured activities like swimming, cycling, and sports. Physical activity in children and young people is essential for healthy development and sets good habits for life.
3. Quit Tobacco
Nicotine exposure increases your risk for a wide range of chronic diseases, including cardiovascular disease. Nicotine reduces “good” cholesterol levels, promotes plaque buildup[mfn]nhlbi.nih.gov[/mfn], and increases the risk of coronary heart disease and stroke by 2 to 4 times[mfn]cdc.gov[/mfn]. Smoking cigarettes is responsible for around a third of deaths from heart disease.
The effects of tobacco are the same whether you smoke traditional cigarettes or use other inhaled nicotine delivery systems like vaping. Secondhand smoke can be just as bad as first-hand smoke. By AHA estimates, around one-third of American children aged 3 to 11 are exposed to secondhand smoke.
The American Heart Association has a handy factsheet[mfn]heart.org[/mfn] with tips for quitting cigarettes and your doctor can give you advice as well. Inform yourself about the risks of smoking—both for yourself and those around you—and focus on the benefits of quitting. With a solid strategy and perseverance, you can kick the habit and improve your heart health.
4. Get Enough Sleep
Healthy sleep is the newest addition to the AHA’s Essential 8. This metric was added because—in the words of the AHA—”adequate sleep promotes healing, improves brain function, and reduces the risk for chronic diseases.”
Poor sleep health increases the risk of high blood pressure, obesity, dementia, depression, and cardiovascular disease, and tends to lead to poor food choices and increased cigarette smoking, which compound the negative effects of sleep deprivation on heart health.
The ideal sleep duration for an adult is 7-9 hours. Fewer than 7 hours is considered sleep deprivation and sleeping for more than 9 hours each night has been linked with health problems[mfn]webmd.com[/mfn] including diabetes, obesity, headaches, back pain, depression, heart disease, and an increased overall risk of death.
Children need:
- 10-16 hours of sleep per 24 hours for ages 5 and below
- 9-12 hours for children aged 6 to 12
- 8-10 hours for teens aged 13 to 18
To improve sleep health, the AHA recommends:
- Charging devices away from your head at night
- Turning off notifications on your device at night
- Dimming your screen after dark or using a red-light filter
- Using an app-blocking app to stop yourself from checking your email or playing games on your device at night
- Setting a bedtime alarm to remind yourself to go to bed
5. Manage Weight
Obesity is a common risk factor for heart disease as well as heart attack and sudden cardiac arrest. By keeping yourself at a healthy weight, you decrease your risk for many kinds of diseases (including heart disease and type 2 diabetes) and put less pressure on your joints.
Body mass index is often used as a gauge for determining what a healthy weight would be for any individual. Your BMI is a numerical value determined by dividing your weight in kilograms (kg) by your height in meters (m) squared (you can use the NIH standard body mass index calculator[mfn]nhlbi.nih.gov[/mfn] to determine your BMI). A BMI of 20-25 is considered healthy.
If you do need to lose weight, the AHA recommends:
- Learning about portion sizes and reducing the amount of food you eat if you currently eat more calories than you need
- Moving more and increasing the intensity of your exercise to burn more calories
- Eating a diet rich in whole foods like vegetables, fruits, whole grains, legumes, beans, nuts, and lean proteins and limiting processed, salty, and sugary foods
- If you’re overweight and are finding it hard to lose weight on your own, talk with a healthcare professional.
6. Control Cholesterol
Cholesterol is a fatty substance that’s produced by your body. It’s also present in animal foods.
There are two types of cholesterol:
- HDL or high-density lipoprotein. HDL is considered good for heart health because it works to keep LDL from sticking to the artery walls and helps to reduce plaque buildup.
- LDL or low-density lipoprotein. LDL is considered bad for heart health because it sticks to the artery walls and causes plaque buildup.
To keep your blood cholesterol in the healthy range:
- Check your blood lipids every four to six years, including HDL and non-HDL cholesterol levels as well as triglycerides, which affect your total cholesterol level. People with heart disease or diabetes may need to be tested more often.
- Eat plenty of whole foods and limit salty and sugary foods, red and processed meats, refined carbs, and highly processed foods.
- Stay active by sitting less, moving more, and increasing the intensity of your weekly exercise regimen.
- Consume unsaturated fats (like avocado and olive oil) instead of saturated fats, the type of fat that’s present in hamburgers, sausages, cured meats, cookies, and cheese.
- Avoid cigarette smoke. Nicotine lowers (good) HDL cholesterol and increases your risk of heart disease.
- If your doctor prescribes statins or other cholesterol-lowering medications, take these medications consistently as prescribed.
7. Manage Blood Sugar
High levels of blood sugar can cause damage to the heart, nerves, kidneys, and eyes. High blood sugar is also a risk factor for developing Type 2 diabetes, which in turn is a risk factor for cardiovascular disease and stroke.
To know whether your blood sugar levels are healthy, a medical professional can take a blood glucose reading and tell you whether your levels are normal, pre-diabetic, or diabetic.
- A fasting blood glucose level below 100 mg/dl is considered normal.
- A fasting blood glucose level between 100 and 125 mg/dl is described as prediabetic, meaning that the patient is at increased risk of developing diabetes.
- A fasting blood glucose level of 126 mg/dl or higher indicates a Type 2 diabetes diagnosis. Patients with diabetes have a higher risk of heart disease and stroke.
To keep your blood glucose levels healthy:
- Eat a heart-healthy diet.
- Get at least the minimum amount of exercise recommended by the CDC.
- Stick to a healthy weight and lose weight if you’re overweight.
- Avoid cigarette smoking, as nicotine may make it harder to manage prediabetes and diabetes.
8. Manage Blood Pressure
High blood pressure puts additional strain on your heart, which is why keeping your blood pressure in the healthy range is one of the eight pillars of a heart-healthy lifestyle.
- Normal or healthy blood pressure is anything lower than 120/80.
- Blood pressure between 120/80 and 129/80 is considered elevated.
- Blood pressure between 130/80 and 139/89 is considered high blood pressure (hypertension) Stage 1.
- Blood pressure of 140/90 or higher is considered high blood pressure (hypertension) Stage 2.
- A systolic blood pressure (top number) higher than 180 and/or a diastolic blood pressure (bottom number) higher than 120 signifies a hypertensive crisis. Seek medical attention immediately.
You can lower blood pressure naturally by:
- Eating a nutritious diet focused on whole foods
- Getting enough physical activity
- Quitting cigarettes
- Improving the quality and length of your sleep
See How You’re Doing with the “My Life Check” Assessment Tool
Curious about how your health behaviors rate on the AHA’s Essential 8? You can find out by completing the My Life Check assessment[mfn]mlc.heart.org[/mfn], an online tool that was developed as a way of quantifying cardiovascular health.
To complete the assessment, you will need:
- An estimate of your intake of various kinds of foods and beverages
- Estimates of your hours of physical activity and sleep
- A recent blood pressure reading
- Recent cholesterol levels (total cholesterol and HDL cholesterol)
- Recent blood sugar levels (fasting or A1c)
- Your height in feet and inches
- Your weight in pounds
Once you’ve entered your personal information, the program uses an algorithm that aggregates your scores for each metric (out of 100) to give you a composite cardiovascular health score (also as a number out of 100). When you receive your score, you can view your individual scores for each metric to see what you need to do to improve your cardiovascular health.
How Americans Track on the MLC Scale
The Prevalence Estimates from the National Health and Nutrition Examination Survey [mfn]health.gov[/mfn](NHANES), 2013-2018, provide an indication of how Americans track on each of the AHA’s Essential 8. This data is taken from The Cooper Institute website. As you’ll see, the three categories in which people scored the lowest were diet, physical activity, and body weight.
| Metric | Men | Women |
| Diet | 38.1 | 51.9 |
| Physical Activity | 54.0 | 49.2 |
| Nicotine Exposure | 63.1 | 75.1 |
| Sleep Duration | 84.0 | 85.3 |
| Body Weight | 57.8 | 57.1 |
| Body Cholesterol | 64.8 | 69.9 |
| Blood Sugar | 76.8 | 80.0 |
| Blood Pressure | 67.6 | 73.8 |
The data can also be broken down by racial group. In this table, the numbers represent each group’s average composite score.
| Racial Group | Average Composite Score |
| Non-Hispanic Black | 59.7 |
| Non-Hispanic White | 65.7 |
| Mexican | 62.8 |
| Other Hispanic | 65.1 |
| Asian | 68.5 |
No matter how you’re tracking now or how your scores compare to the average for your racial group, everything you do to improve your heart health now will provide long-term benefits and reduce your risk of heart disease and early death.
How Prevention and Emergency Preparedness Work Together to Save Lives
At AED Leader, our main focus is equipping Americans to respond quickly and effectively when someone goes into sudden cardiac arrest. To this end, we provide first aid and AED training and sell automated external defibrillators from the top six FDA-approved brands, including perennial favorites like the Physio-Control LIFEPAK CR2 and the Philips HeartStart FRx.
However, while preparing for cardiac arrest is essential—AEDs save around 1,700 additional lives in the United States every year[mfn]nih.gov[/mfn] and are mandated by law in many businesses and institutions—working on heart-healthy lifestyle habits could prevent you from ever developing heart disease and drastically lower your risk for heart attack, stroke, and cardiac arrest.
Cardiac Arrest Happens to Healthy People Too
As a counterbalance to what we’ve just said, even healthy people with no known risk factors can suffer cardiac arrest. High-profile deaths due to SCA among athletes, including marathon runners and basketball players, are proof of the fact that anyone can suffer sudden cardiac arrest, no matter how healthy and fit they are.
For this reason, the best approach is to follow the AHA’s Essential 8 and prepare for SCA by learning cardiopulmonary resuscitation and knowing where your nearest AEDs are located. With immediate chest compressions and rapid defibrillation (delivered with an onsite AED), SCA survival rates can be as high as 85%[mfn]ncbi.nlm.nih.gov[/mfn] compared to less than 10% when nothing is done before emergency medical services arrive.
Life’s Essential 8 Combined with CPR and Defibrillators Could Save Hundreds of Thousands of Lives Every Year
In the United States, around 365,000 people suffer out-of-hospital cardiac arrests each year, according to data from the American Heart Association. Furthermore, cardiovascular disease was the underlying cause of death for more than 874,000 Americans in 2019[mfn]professional.heart.org[/mfn]. However, according to the World Health Organization, up to 80% of premature heart attacks and strokes are preventable with lifestyle changes. And as we mentioned earlier, up to 85% of SCA deaths could be prevented with widespread training and ready access to AEDs.
To live your best life and help those you love, taking the importance of heart health seriously applying the AHA’s Essential 8 is an excellent place to start. Then, learn CPR and how to use an AED and know where to find a defibrillator in an emergency (there are often portable defibrillators in hospitals, schools, fitness clubs, shopping malls, public buildings, and dental offices). Once you combine these two powerful tools, you could potentially save multiple lives!
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