The preventive cardiovascular health concept: "Life's Essential 8", a new score to test yourself and take action!

In 2010, the American Heart Association (AHA) defined a new, more preventive and comprehensive approach to cardiovascular health. At the time, the AHA was already promoting the need for a change in our medical approach, which was too focused on curative care and not enough on prevention. The American experts recommended a more global approach, with the promotion and preservation of health throughout the lives of populations and individuals, and to this end devised an ideal cardiovascular health score: Life's Simple 7, on which anyone can test themselves and change their lifestyle habits. The score is freely available on the Internet, and includes a calculator with 7 items: 1. stop smoking; 2. eat a healthy diet; 3. engage in regular physical activity; 4. Lose weight if necessary; 5. Control blood pressure; 6. Control cholesterol; 7. Reduce sugar intake. Each item is worth 2 points if ideal, so ideal health is worth a total of 14 points. (https://www.soapnote.org/cardiovascular/lifes-simple-7/).
Subsequently, numerous publications have assessed the strengths and limitations of this original approach to quantifying overall cardiovascular preventive health. As a result of these developments, the American Heart Association has recently recommended improvements with an update of this comprehensive approach. The definition and quantification of each of the original 7 elements of Life's Simple 7 have been re-evaluated for their relevance to individual change. New measures were proposed, and the age spectrum was broadened to include the entire life course. The fundamental contexts of the social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This position paper introduces an enhancement of this holistic approach with 3 updates: smoking, lipids and blood sugar and a new addition, sleep: "Life's Essential 8" which can be accessed at https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8.
The 8 components include :
- a healthy diet
- good physical activity
- no smoking
- good sleep
- normal weight
- normal blood lipid levels
- normal blood glucose levels
- normal blood pressure levels.
A new "scoring algorithm" is proposed, ranging from 0 to 100 points, to establish this new cardiovascular health score. It is naturally suggested that this new test be taken into account to promote widespread adoption in policy circles, public health, routine medical practice as well as institutional and community settings.


Comment by our expert, Dr. Jean-François Renucci:
The initiative is commendable. Communicating on so-called "primordial" prevention, i.e. changing our health behaviors even before risk factors appear, is ambitious and logical. This preventive approach should be promoted as a reaction to the approach of treating only the risk factor (primary prevention) or the disease that has already set in (secondary and tertiary prevention).
In order to provide you with more precise, quantified data for these 8 elements of the score, and adapted to the French population, you should ideally adopt the following behaviours as early as possible:
- Mediterranean-style diet
- Physical activity: minimum 30 minutes every day
- Smoking: 0
- Sleep: more than 6 hours per night
- Weight: Body Mass Index (BMI) between 20 and 25
- Lipids: LDL cholesterol no more than 1.3 g/l - Triglycerides no more than 1.5 g/l
- Glucose: fasting blood glucose close to 1 g/ml
- Blood pressure: maximum or systolic below 140 mm Hg, minimum or diastolic below 90 mm Hg
All this, ideally without treatment, to guarantee the best possible outcome with minimum risk of cardiovascular disease.
Act rather than suffer for prevention in action, as the co-founders of Agir pour le Cœur des Femmes, Professor Claire Mounier-Véhier and Thierry Drilhon, regularly emphasize.

Reference:
Lloyd-Jones D.M. et al: Life's Essential8: Updatind and enhancing the American Heart Association's construct of cardiovascular health. Circulation, 2022; 146: e18-e43.