A comprehensive new analysis sheds light on the cardiovascular health of older adults in the United States, revealing troubling declines in heart health metrics among those living with certain cardiovascular diseases. Drawing upon extensive data from the National Health and Nutrition Examination Survey (NHANES) collected between 2013 and 2018, this research employed the American Heart Association’s Life’s Essential 8 (LE8) health framework to assess the cardiovascular wellness of adults aged 65 and older. The results highlight not only a stark disparity between those with and without cardiovascular disease but also an alarming downward trajectory in key health indicators over the five-year period.
The Life’s Essential 8 is a recently refined set of cardiovascular health metrics developed by the American Heart Association to better gauge heart and brain health. These eight components integrate four health behaviors—diet, physical activity, smoking status, and sleep—and four health factors—body mass index (BMI), cholesterol, blood sugar, and blood pressure. This comprehensive approach allows for nuanced insight into the interplay between lifestyle choices and physiological markers of cardiovascular wellness. Each component is scored on a scale from 0 to 100, with higher scores indicating optimal health. These are averaged to produce an overall cardiovascular health score, where scores below 50 signal low health, between 50 and 79 indicate moderate health, and 80 or above represent high cardiovascular health.
The present study analyzed data from 3,050 adults representative of approximately 37.9 million Americans aged 65 or older. The participants’ cardiovascular status was self-reported, encompassing conditions such as coronary heart disease, stroke, heart failure, high blood pressure, heart-related chest pain, and heart attacks, as well as individuals without any reported cardiovascular condition. This stratification allowed researchers to compare cardiovascular health scores across these subgroups, illuminating the gradient of decline associated with disease burden.
One of the key findings revealed that older adults without diagnosed cardiovascular disease maintained an average cardiovascular health score of 68, classified as moderate health. In stark contrast, individuals living with one or more cardiovascular diseases had scores below 60, with a pronounced tendency for scores to drop as additional cardiovascular conditions accumulated. This dose-response relationship underscores the compounded effect of multiple cardiovascular ailments on overall cardiovascular wellness metrics.
Further analysis uncovered significant declines in cardiovascular health across several disease groups during the years studied. Notably, participants with high blood pressure experienced a 4.1% reduction in their LE8 scores, decreasing from 59.6 in 2013 to 57.1 in 2018. The decline was even more pronounced among those with a history of stroke, who suffered an 11.5% drop from 60.6 to 53.6, and most severe in individuals with heart failure, where scores plummeted by 15.2% from 60.9 down to 51.6. These statistics highlight worsening cardiovascular metrics in a vulnerable and growing demographic segment, intensifying calls for focused preventive and management strategies.
Analysis of specific LE8 components pointed to blood pressure and physical activity as the primary drivers of the health gap between those with and without cardiovascular disease. Lower scores in these areas were consistently observed among participants with cardiovascular conditions, suggesting that therapeutic and lifestyle interventions targeting blood pressure control and increased physical activity could yield significant improvements in cardiovascular health. Effectively, these two modifiable factors disproportionately influence the cardiovascular health inequities evident in older adults.
The study’s implications extend beyond highlighting existing health disparities; they emphasize the urgency of early, sustained intervention. According to study co-author James M. Walker, a medical and business dual-degree student, the research establishes a crucial baseline for the cardiovascular health status of the elderly population before the COVID-19 pandemic, a period during which older adults suffered disproportionately from cardiovascular complications. This foundational insight sets the stage for future longitudinal studies examining how cardiovascular health trajectories have evolved through and beyond the pandemic era.
While aging naturally introduces challenges to maintaining optimal health, the findings underscore that cardiovascular decline is not an inevitable consequence of age alone but is heavily influenced by the presence and number of cardiovascular diseases compounded by lifestyle factors. This insight strengthens the case for proactive health promotion throughout the lifespan, encouraging adherence to Life’s Essential 8 starting from early childhood to foster resilience against cardiovascular deterioration in later years.
The study authors caution readers about the research’s limitations, emphasizing its cross-sectional design which restricts conclusions regarding causality. Data were collected from discrete groups of participants rather than tracking the same individuals over time, limiting definitive interpretations about the progression of cardiovascular health. Furthermore, the study addressed six common cardiovascular disease categories, potentially omitting less prevalent conditions that contribute to cardiovascular health dynamics in this population.
Demographically, the study cohort was predominantly white (79.9%), with representation from Black, Asian, Mexican, Hispanic, and other racial and ethnic groups, reflecting the diverse makeup of the U.S. elderly population. This diversity affirms the study’s relevance to a broad patient demographic but also signals the need for further research to examine cardiovascular health disparities across racial and ethnic lines more deeply.
In light of these findings, healthcare providers are encouraged to intensify efforts to support cardiovascular health in older adults, focusing on blood pressure management and increased physical activity. The American Heart Association’s broader mission advocates for accessible education and community resources designed to empower older individuals to maintain healthier lifestyles and mitigate the progression of cardiovascular diseases. Such initiatives are increasingly vital as the Baby Boomer generation approaches and surpasses the age of 65, heralding a substantial demographic shift with significant public health implications.
Dr. Stacey E. Rosen, volunteer president of the American Heart Association, underscores the significance of this research against the backdrop of a growing elderly population with complex cardiac histories. She emphasizes that medical advances have extended life expectancy, even after major cardiovascular events like heart attacks and strokes, making sustained management essential. By prioritizing early intervention and ongoing support, health systems can enable older adults to maximize quality of life and functionality despite cardiovascular challenges.
Overall, the study reveals a critical aspect of public health, demonstrating that cardiovascular health is deteriorating among older adults afflicted with certain cardiovascular diseases, driven largely by insufficient blood pressure control and low physical activity levels. The insights invite renewed focus on holistic, multidimensional interventions guided by Life’s Essential 8, aiming to gradually reverse these trends and foster better cardiovascular outcomes in the aging population.
Subject of Research: Cardiovascular health trends among older U.S. adults with cardiovascular diseases using Life’s Essential 8 metrics
Article Title: Comparing the “Life’s Essential 8” Scores of Older Adults Living With Cardiovascular Diseases: NHANES, 2013 to 2018
News Publication Date: August 20, 2025
Web References:
– https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8
– https://www.ahajournals.org/journal/jaha
– https://dx.doi.org/10.1161/JAHA.124.039659
References: Article published in the Journal of the American Heart Association, DOI: 10.1161/JAHA.124.039659
Keywords: Cardiovascular disease, cardiovascular health, Life’s Essential 8, blood pressure, physical activity, older adults, NHANES, heart failure, stroke, high blood pressure
