Life's Essential 8: Higher Scores Extend Health Span

JoAnn E. Manson, MD, DrPH


March 27, 2023

This transcript has been edited for clarity.

This is Dr JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women's Hospital. I'd like to talk with you about a recent report on the American Heart Association (AHA) Life's Essential 8 metric and its association with both life expectancy and health span or life expectancy free of chronic diseases such as cardiovascular disease (CVD), cancer, diabetes, and dementia.

This study leveraged the UK Biobank and included more than 135,000 UK adults with a mean age of 55. The AHA metric was defined as including the following lifestyle behavioral factors:

  • Not smoking;

  • Regular physical activity;

  • Healthy weight;

  • Healthy diet;

  • Healthy sleep (defined as an average of 7-9 hours nightly);

  • Blood pressure in a healthy range:

  • Blood glucose in a healthy range; and

  • Non-HDL cholesterol in a healthy range.

This study was just published in JAMA Internal Medicine. I'd like to acknowledge that I'm a coauthor of this study, along with my colleagues at Tulane.

We divided the study population into three groups: those with low, moderate, and high scores on the Life's Essential 8 metric — low, moderate and high cardiovascular health. Overall, the average life expectancy free of chronic disease was estimated (at age 50) to be 25 additional years in men and 30 additional years in women.

We saw large differences across the Life's Essential 8 metric group. Men with high cardiovascular health scores tended to have an additional 7 years of life expectancy free of chronic disease compared with those who had lower scores. In women, the difference was about 9.5 years between high scores and lower scores. Also, the number of years lived with chronic disease was compressed in those with high cardiovascular health scores. They tended to have fewer years living with those chronic diseases but more years living free of chronic diseases.

We were interested in how these results might differ by socioeconomic status, educational level, and income level, as well as the Townsend deprivation index. We were intrigued by the finding that the gain in life expectancy free of chronic disease was very similar across all socioeconomic strata. Even those with lower education and income gained as much chronic disease–free life expectancy as those who were in the higher socioeconomic strata.

Overall, the findings make a compelling case for the importance of lifestyle factors in extending health span and years free of chronic disease. It can be motivating to tell our patients that a healthy lifestyle not only extends life expectancy but also extends years of health free of chronic disease.

Nonetheless, we do have many disparities in life expectancy and health span. So it will be very important to population health to narrow those health disparities through education about the importance of lifestyle factors, more research on implementation of lifestyle factors and behaviors, and public policy to make a healthy lifestyle both affordable and accessible to all people across all of these socioeconomic groups.

Thank you so much for your attention. This is Joann Manson.

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