Heart disease remains the leading cause of death in the United States, and the American Heart Association's way of measuring heart health fits on one page. It is called Life's Essential 8: eight measures, each scored from 0 to 100, averaged into a single number. Knowing the targets makes it easy to see where you already stand and which number is pulling the average down.

Where it comes from

The AHA introduced Life's Essential 8 in a presidential advisory published in Circulation on June 29, 2022, led by Donald Lloyd-Jones of Northwestern University. It replaced the association's earlier Life's Simple 7, adding sleep as a new measure and changing how the others are scored. Instead of rating each factor as simply poor, intermediate or ideal, every measure now runs on a 0 to 100 scale, so small improvements register.

The eight measures and what earns 100 points

The advisory splits them into four behaviors and four health factors. For adults, the top score on each looks like this:

  • Physical activity: 150 minutes or more of moderate-intensity activity a week, the same as the federal Physical Activity Guidelines.
  • Sleep: 7 to under 9 hours a night on average. Both too little and too much score lower.
  • Nicotine exposure: never having smoked. The score drops by 20 points for living with an indoor smoker, and vaping counts as nicotine exposure.
  • Diet: an eating pattern close to the DASH or Mediterranean style, scored with a short questionnaire for individuals.
  • Body mass index: under 25.
  • Blood lipids: non-HDL cholesterol under 130 mg/dL. Non-HDL is total cholesterol minus HDL, and it is printed on most standard lipid panels.
  • Blood glucose: no history of diabetes and a fasting glucose under 100 mg/dL or an A1c under 5.7 percent.
  • Blood pressure: under 120 systolic and under 80 diastolic.

Scores fall in steps below each target. Being on medication for blood pressure, cholesterol or glucose lowers that measure's score even when the number itself is controlled, which reflects that treated risk is not the same as no risk.

How the total works

The overall score is the plain average of the eight, with no measure weighted more than another. The AHA groups results into three bands: 80 to 100 is high cardiovascular health, 50 to 79 is moderate, and 0 to 49 is low. Because each measure counts equally, a weak score on sleep or activity drags the total just as much as a weak score on blood pressure.

Why sleep was added

The advisory's authors pointed to a body of research linking short and irregular sleep to higher blood pressure, weight gain and worse glucose control. Adding it brought the score in line with how heart researchers now describe overall cardiovascular risk.

What the score is and is not

Life's Essential 8 is a measure of cardiovascular health, not a diagnosis and not a ten-year risk calculator. It does not account for family history, age or a past heart attack, all of which a clinician weighs separately. It is designed so people and doctors can track change over time and see which habits or numbers are moving.

Working out your own

Four of the eight (activity, sleep, nicotine and diet) are things you can estimate tonight. The other four need numbers: a recent blood pressure reading, which a validated home cuff can provide, and a basic blood panel with cholesterol and glucose from a routine physical. Bringing the eight targets to that appointment turns a lab printout into a clear list of what is on target and what is not.

This article reports research and expert guidance. It is not medical advice. Talk to your clinician before changing medication, treatment or a medical diet.

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