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American Heart Association sets 2020 impact goal

AHA defines 'ideal' cardiovascular health

For the first time, the American Heart Association has defined "ideal cardiovascular health," identifying seven health factors and lifestyle behaviors that support heart health.

The association created the definition as part of its effort to achieve its new national goal: By 2020, improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent. The novel focus of the new goal will be preventing heart disease and stroke, most notably by helping people identify and adopt healthier lifestyle choices. This will be the first time the American Heart Association has adopted better health as a principal goal.

In a recent survey of adult Americans, the association found 39 percent said they thought they had ideal heart health; however, 54 percent of those (and 70 percent of all respondents) said a health professional had told them they had a risk factor for heart disease and/or needed to make a lifestyle change to improve their heart health. These findings indicate most people don't associate important risk factors, such as poor diet and physical inactivity, with cardiovascular disease.

"To date, there has been great success in reducing disability and death from heart disease and stroke in part through aggressive improvements in the diagnosis and treatment of these diseases and in limited uptake of measures to prevent heart disease and stroke," said Clyde W. Yancy, M.D., American Heart Association president. "We achieved our 2010 goal of reducing death by heart disease and stroke by 25 percent -- earlier and by a wider margin than we had targeted. However, too many people continue to have unrelenting exposure to known important risk factors for heart disease and stroke to the point that we are likely to begin seeing an increase in these diseases -- and at an earlier age. That is a cause for alarm and a trend we need to stop now."

In a scientific statement published in Circulation: Journal of the American Heart Association, the association described seven health factors and lifestyle behaviors that can affect optimal cardiovascular health. Improvements in these areas can greatly impact quality of life and life span, as well as dramatically reduce the financial burden of the Medicare-eligible population, said Donald M. Lloyd-Jones, M.D., Sc.M., lead author of the statement.

"If we reach people in middle age and even younger with this message, we could change American health for the better for decades to come," said Lloyd-Jones, chair of the Department of PreventiveMedicine and associate professor of Preventive Medicine and Medicine at Northwestern University Feinberg School of Medicine in Chicago.

For the 2020 impact goal, the association categorizes cardiovascular health as poor, intermediate or ideal -- depending on where people are in each of the seven areas. While the metrics for children vary based on pediatric recommendations and guidelines, ideal cardiovascular health for adults is defined by the presence of these seven health measures, known as Life's Simple 7:

* Never smoked or quit more than one year ago;

* Body mass index less than 25 kg/m2;

* Physical activity of at least 150 minutes (moderate intensity) or 75 minutes (vigorous intensity) each week;

* Four to five of the key components of a healthy diet consistent with current American Heart Association guideline recommendations;

* Total cholesterol of less than 200 mg/dL;

* Blood pressure below 120/80 mm Hg;

* Fasting blood glucose less than 100 mg/dL.

"Ideal" health can be difficult to achieve, in part because genetics can play an important role in several of the health factors, Lloyd-Jones said. But he said everyone should strive to reach his or her optimal level of heart health. He said the first step is to know your heart health numbers -- cholesterol, blood pressure, glucose -- and what they mean. The next step is to try to reach as close to "ideal" as you can.

"Essentially, everyone is a candidate to take at least one step forward in these metrics, from poor to intermediate or intermediate to ideal, to move a substantial portion of the population and have a real impact on cardiovascular health," he said.

To help people improve their heart health, the American Heart Association has developed a new online resource, My Life Check (www.heart.org/MyLifeCheck). The short assessment easily identifies the seven goals for ideal health and notes where a person is on the spectrum, while additional tools and information offer specific action steps to improve the measurements and track personal progress toward better health.

"A simple step-by-step approach has now been developed that delivers on the hope we all have -- to live a long, productive, healthy life. We call it Life's Simple 7," said Yancy, medical director of the Baylor Heart and Vascular Institute at Baylor University Medical Center in Dallas. "Any favorable movement on these proven measures will lead to better outcomes."

The association will partner with health care and government agencies and those in other arenas to make policy and environmental changes to help move Americans toward ideal cardiovascular health.

"It's simple. Of all the treatment strategies that work for heart disease and stroke, the best treatment is to avoid disease altogether," he said. "Prevention should be a cornerstone of health care reform, a priority of our state and local legislatures, incorporated into our workplace policies, in our schools and our community environments, and a big part of our everyday lives. The American Heart Association is clearly focusing not only on reducing the burden of disease but, importantly, on prevention of disease. That should matter to everyone."

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