The August Health Report detailed the online scoring tool of the American Heart Association Hear (AHA) that calculates a simple yet evidence-based score to determine heart health focusing on risk factors which users can control while including some they cannot.
Those who take the challenge can now better focus on what efforts they can make to cut their risk — and thus make themselves more young at heart which translates to not only less likelihood of having a heart attack or stroke but also dying prematurely of chronic disease. In other words, a low score means you’re not only young at heart but more likely to enjoy younger health in general.
The AHA heart assessment tool factors in both risk factors you can’t change (family medical history and age) as well as risk factors you CAN change. Knowing both is helpful because instead of “giving up” concluding that “I’m too old” or “There’s heart disease in my family” saying I’m at higher risk and can’t do anything about it, they can take the opposite approach and by being motivated to work harder at reducing those risk factors they have control over.
The Eight Components of heart risk you CAN change
The AHA organized the eight metrics into two groups. The first four are health behaviors, the things you control through daily choices. The second four are health factors, the things measured by your body or a lab test. Both groups matter equally, and each component scores from 0 to 100.
1. Diet is scored against how consistently your meals and snacks are fruits, vegetables, whole grains, nuts, legumes, fish, and healthy fats with minimal processed food, added sugars, and excess sodium? Americans consistently score the lowest in this component in the country, with mean scores ranging from the low 20s to the upper 40s. While that’s bad news, the food news is almost everybody has room to improve here.
2. Physical activity is measured as minutes of moderate or vigorous activity per week. For adults, the benchmark for a perfect 100 is 150 minutes or more of moderate-intensity activity (or the equivalent in vigorous activity, where each vigorous minute counts double).
3. Nicotine exposure was significantly updated from the earlier framework. The old metric only counted cigarette smoking. The current version includes e-cigarettes, vaping devices, and secondhand smoke exposure. If you live with an active indoor smoker, your score takes a 20-point hit even if you’ve never touched a cigarette yourself.
4. Sleep is the newest component with the optimal range for adults is 7 to under 9 hours per night. Both too little and too much sleep reduce your score, reflecting the well-established U-shaped relationship between sleep duration and health outcomes. Six hours drops you to 70 points, five hours or 10-plus drops you to 40, and under four hours earns a zero. Sleep is associated with every other component on the list, affecting blood pressure, blood glucose, weight, dietary choices, and activity levels.
5. Body mass index is scored using standard BMI thresholds, with a perfect score generally assigned for a BMI under 25. The AHA explicitly acknowledges that BMI is an imperfect metric. It doesn’t distinguish between muscle mass and fat mass. Clinical judgement rather than automatic scoring may be appropriate for lean individuals with high muscle mass. Despite its limitations, BMI remains the most widely available and routinely calculated measure, which is why the framework uses it.
6. Blood lipids were updated to use non-HDL cholesterol instead of total cholesterol. The calculation is simple if you have a standard lipid panel: take your total cholesterol and subtract your HDL cholesterol. The number you’re left with is your non-HDL cholesterol.
7. Blood glucose is measured by fasting blood glucose or HbA1c. For someone with no history of diabetes, a fasting glucose under 100 or A1c under 5.7% earns a perfect 100.
8. Blood pressure is scored using the thresholds from the 2017 ACC/AHA hypertension guideline. Optimal is under 120/80 for a full 100 points
While it would be unrealistic to score 100 on each of these modifiable cardiac measures, the higher you score, the more you can claim to be “young at heart.” Here’s to a high score!
