Life’s Simple 7

Life’s Simple 7
icon-smokers 1. Stop Smoking
icon-checkup 2. Eat Better
icon-checkup 3. Get Active
icon-checkup 4. Lose Weight
icon-checkup 5. Manage Blood Pressure
icon-checkup 6. Control Cholesterol
icon-checkup 7. Reduce Blood Sugar

The American Heart Association’s 2020 Impact Goal of improving the cardiovascular health of all Americans 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent underscores the organization’s focus on prevention. Using the best available evidence, AHA developed a prescription for health called Life’s Simple 7 – the seven most important predictors of heart health and also a pathway for achieving ideal cardiovascular health. The Simple 7 include four modifiable behaviors (not smoking, healthy weight, eating healthy and being physically active) and three biometric measures (blood pressure, cholesterol and blood sugar). These seven factors are classified into three categories: ideal, intermediate and poor. For example, adults with a Body Mass Index (BMI) greater than 30 are classified as “poor,” “intermediate” with a BMI 25–29.9 and “ideal” if they have a BMI 18.5-25 [see Table 1]. Individuals with ideal levels for all seven metrics are considered to have ideal cardiovascular health.

Table 1.
Definitions of Poor, Intermediate, and Ideal Cardiovascular Health for Each Metric
in the AHA 2020 Goals for Adults Aged ≥20 Years

Level of Health for Each Metric
Poor Intermediate Ideal
Current smoking Yes Former ≤ 12 months Never or quit >12 months
Never tried; never smoked
whole cigarette
BMI* ≥30 kg/m2 25-29.9 kg/m2 18.5-25 kg/m2
PA† None 1-149 min/week moderate
or
1-74 min/wk vigorous
1-149 min/wk moderate + 2x
vigorous
>0 min <60 min of moderate or
vigorous every day
≥150 min/wk moderate
or
≥75 min/wk vigorous
≥150 min/wk moderate
+ 2x vigorous
≥60 of moderate or vigorous
every day
Healthy diet pattern,
number of components ‡
0-1 2-3 4-5
Total cholesterol ≥240 mg/dL 200-239 mg/dL or treated to goal <200 mg/dL
Blood pressure SBP ≥140 mmHg
or
DBP ≥90 mmHg
SBP 120-139 mmHg
or
DBP 80-89 mmHg
or
treated to goal
<120 mmHg/ <80 mmHg
Fasting plasma glucose ≥126 mg/dL 100-125 mg/dL <100 mg/dL

AHA indicates American Heart Association; BMI, body mass index; DBP, diastolic blood pressure; PA, physical activity; and SBP, systolic blood pressure

*Represents appropriate energy balance (i.e., appropriate dietary quantity and PA to maintain normal body weight).
†Proposed questions to assess PA: (1) “On average, how many days per week do you engage in moderate to strenuous exercise (like a brisk walk)?” and (2) “On average, how many minutes do you engage in exercise at this level?” Other options for assessing PA available.
‡In the context of a healthy dietary pattern that is consistent with a Dietary Approaches to Stop Hypertension (DASH)–type eating pattern, to consume ≥4.5 cups/d of fruits and vegetables, ≥2 servings/wk of fish, and ≥3 servings/d of whole grains and no more than 36 oz/wk of sugar-sweetened beverages and 1500 mg/d of sodium.

It is never too late to adopt healthier behaviors and habits — evidence shows that a 50-year-old with ideal cardiovascular health has substantially lower lifetime risk for cardiovascular disease and markedly longer survival.1 Unfortunately, several surveys have shown that very few American adults have ideal cardiovascular health, perhaps as few as one percent of the population. In fact, only 18 percent of adults have five or more metrics with ideal levels, with lower prevalence among men (11%) compared to women (25%).2 Studies have also shown that people who meet three to four of Life’s Simple 7 measures reduce their risk of heart-related death by more than half. However, an AHA Nielsen study showed that most people do not know their Life’s Simple 7 numbers and most U.S. adults overestimate their heart health: 39 percent of people surveyed thought they were in ideal cardiovascular health whereas studies show that only roughly one percent of Americans actually have ideal levels for all seven metrics.


An estimated 20 percent to 30 percent of companies’ annual healthcare costs are spent on employees with 10 modifiable risk factors, seven of which make up Life’s Simple 7.

An estimated 20 to 30 percent of companies’ annual healthcare costs are spent on employees with 10 modifiable risk factors. These include the seven risk factors that make up Life’s Simple 7: cigarette smoking, obesity, hypertension, high cholesterol, physical inactivity, poor diet and diabetes.3 Employers can use the science of Life’s Simple 7 to assess the heart health of their employees and monitor progress towards improved heart health. Furthermore, by promoting healthy lifestyle behaviors and addressing modifiable health behaviors in addition to biometric screenings, organizations can see an improvement in the overall heart health of their workforce.4

Based on the science of Life’s Simple 7, AHA has also created My Life Check®, an innovative, science-based online heart health assessment tool. My Life Check leads users through a health assessment that identifies the greatest opportunity for improvement and generates a personal Heart Health Score and a customized action plan. When used in the workplace, My Life Check can support workplace health by providing employees with custom recommendations to track and improve their Life’s Simple 7 metrics.

Learn more about how My Life Check can help you improve the health of your workforce at heart.org.

References

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Additional Life’s Simple 7 Resources
The AHA’s website at heart.org has a wealth of information to help you and your employees improve Life’s Simple 7 metrics.

Stop Smoking
Cigarette smokers have a higher risk of developing cardiovascular disease. If you smoke, quitting is the best thing you can do for your health.
Learn how to stop smoking.

Eat Better
A healthy diet is one of your best weapons for fighting cardiovascular disease. When you eat a heart-healthy diet, you improve your chances for feeling good and staying healthy – for life!
Learn how to eat better.

Get Active
Living an active life is one of the most rewarding gifts you can give yourself and those you love. Simply put, daily physical activity increases your length and quality of life.
Learn how to get active.

Lose Weight
When you shed extra fat and unnecessary pounds, you reduce the burden on your heart, lungs, blood vessels and skeleton. You give yourself the gift of active living, you lower your blood pressure and you help yourself feel better, too.
Learn how to lose weight.

Manage Blood Pressure
High blood pressure is a major risk factor for heart disease and stroke. When your blood pressure stays within healthy ranges, you reduce the strain on your heart, arteries, and kidneys which keeps you healthier longer.
Learn how to manage your blood pressure.

Control Cholesterol
High cholesterol contributes to plaque, which can clog arteries and lead to heart disease and stroke. When you control your cholesterol, you are giving your arteries their best chance to remain clear of blockages.
Learn how to control your cholesterol.

Reduce Blood Sugar
Most of the food we eat is turned into glucose (or blood sugar) that our bodies use for energy. Over time, high levels of blood sugar can damage your heart, kidneys, eyes and nerves.
Learn how to reduce your blood sugar.