What is Ideal Cardiovascular Health?

  • The American Heart Association defined ideal cardiovascular health based on 7 risk factors.
  • Ideal cardiovascular health is the presence of 7 factors and behaviors that increase the chance of living free of cardiovascular diseases and stroke.
  • To get serious about cardiac health we must all get serious about nutrition since 5 of the 7 parts of ideal cardiovascular health are nutrition based. This observation provides a foundation for the AHA’s population-wide approach that encourages a healthy nutrition pattern.

Shared goals

The goal we all share is to stay healthy and not develop the all to common chronic life-style diseases that affects so many of us such as obesity, diabetes and cardiovascular diseases -such as heart attacks and strokes. Unfortunately only about 3% of the US population can say they meet all components of ideal heart health. The percentage of the population reporting ideal cardiovascular health — defined as having optimal levels of all seven factors — was lowest in Oklahoma, West Virginia, and Mississippi and highest in Washington, D.C., Vermont and Virgininia.

Of great concern is that among “baby boomers” who were 65 or older reported the lowest percentage of ideal heart health while the 35-54 age group reported the highest percentage of ideal heart health. 

The American Heart Association goal is, by the year 2020, to improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent. The majority of the healthy heart components are directly related to a healthy nutrition pattern and clearly more work needs to be done in the promotion of healthier behaviors. Hippocrates, a Greek physician of the Age of Pericles, and Father of Western medicine said it best -more than 2,000 years ago:  “let food be thy medicine, thy medicine shall be thy food.” Sometimes the new is indeed the “old” relearned. The following are the components of optimal cardiovascular health (The Healthy 7):

  1. Never smoked or quit more than one year ago
  2. Maintain a body mass index under 25 kg/m2
  3. Stay physically active for at least 150 minutes at moderate intensity or 75 minutes at vigorous intensity each week
  4. Eat a healthy diet, matching at least four to five of the key dietary components recommended by AHA guidelines, such as low sodium, low sugar-sweetened beverage, high fiber, and fruit and vegetable intake.
  5. Keep total cholesterol under 200 mg/dL
  6. Maintain blood pressure below 120/80 mm Hg
  7. Keep fasting blood glucose less than 100 mg/dL

Heart health is ultimately based on healthy nutrition

Most of the ideal cardiovascular health is ultimately based on healthy nutrition. A healthy nutrition pattern is a nutrient dense diet unique from the standard American or “Western” diet. A direct consequence of a typical American diet and over consumption of so-called: empty calories from refined carbohydrates, excess sodium, and hidden sugars are the twin epidemics of obesity and type 2 diabetes mellitus. Considered life-style diseases both obesity and diabetes are associated with an increased risk for the development of “hardening of the arteries” and atherosclerotic cardiovascular disease –the number one killer of the adult population of Western societies.

Results of randomized controlled studies and large population studies now recognize that an overall healthy nutrition “pattern” as opposed to a focus on single foods or any individual nutrient as fundamental to a good health and optimal cardiovascular health. The Harvard School of Public Health Nurses’ Health Study (NHS), one of the most respected and long-term population studies on the relation of lifestyle and nutrition to major health outcomes like cardiovascular mortality and cancer clearly demonstrated the power of a healthy lifestyle.

  • The 24 year follow-up in the NHS estimated that 55% of all deaths, 44% of cancer, and 72% of cardiovascular mortality could have been avoided by adherence to healthy lifestyle.

A more contemporary large lifestyle study from Sweden repeats the same message: a healthy diet, moderate alcohol use, no smoking, and low waist circumference and more exercise can improve health with a lower risk of heart attack. In sum, together with regular physical activity, the combination of all 5 healthier lifestyle factors was associated with nearly a 80% lower risk of heart attacks.

  • Nearly 80% of those who did suffer heart attacks during the study were attributed to the absence of these simple healthier lifestyle factors.

The components of a healthy lifestyle and ideal cardiovascular health are incorporated in the AHA 2020 Impact Goals and healthy dietary pattern with more fruits and vegetables ≥4.5 cups/day, at least 2 servings per week of preferably oily fish (3.5-oz servings); restricted sodium ≤1500 mg/day and restricted sweets/sugar-sweetened beverages ≤450 kcal (36 oz) per week and increased whole grains: >3 1 oz-equivalent servings/day with avoidance of trans fat (partially hydrogenated fat) and saturated fat; avoidance of processed meats or other highly processed foods (unsalted nuts, seeds, legumes, and vegetable sources of protein and unsaturated fats are preferred substitutes).


The evidence supports a shift in viewing a healthy lifestyle to prevent disease to a new focus on promoting healthy behaviors and all metrics of optimal cardiovascular health. According to Dariush Mozaffarian, MD, DrPH of Tufts University “it is time to prioritize these most basic and fundamental behaviors.” A healthy lifestyle needs to be considered as a primary target for health. Adherence to a healthy lifestyle and nutrition pattern is our goal and our hope is that the MedChefs mobile portfolio of healthy meal planning will provide a helping hand.