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Health Score (Life's Essential 8)

The American Heart Association's Framework for Cardiovascular Health

What is Life's Essential 8?

Life's Essential 8 (LE8) is the American Heart Association's updated framework for defining and measuring cardiovascular health. Released in 2022, it replaces the previous "Life's Simple 7" by adding sleep health as the eighth critical component.

Unlike risk calculators that predict disease probability, your Health Score measures how well you're doing right now across eight key health behaviors and factors that impact cardiovascular health.

Scoring Range: Each metric is scored 0-100, and these are averaged to create an overall cardiovascular health score from 0-100.

The 8 Essential Components

Life's Essential 8 includes 4 health behaviors and 4 health factors:

Health Behaviors (Things You Do)

1. Diet (Eat Better)

Quality of dietary pattern based on the DASH (Dietary Approaches to Stop Hypertension) or Mediterranean diet principles

Scoring: Based on intake of fruits, vegetables, whole grains, nuts/legumes, fish, low-fat dairy, and limiting sodium, sugar, saturated fat, and processed meats

2. Physical Activity (Be More Active)

Total weekly minutes of moderate-to-vigorous physical activity

Optimal: ≥150 minutes/week moderate or ≥75 minutes/week vigorous activity (or equivalent combination)

3. Nicotine Exposure (Quit Tobacco)

Use of cigarettes, e-cigarettes, and secondhand smoke exposure

Optimal: Never smoker and no exposure to secondhand smoke or e-cigarettes

4. Sleep Health (Get Healthy Sleep) — NEW in 2022

Average hours of sleep per night

Optimal: 7-9 hours per night for adults; age-adjusted ranges for children

Health Factors (Numbers That Matter)

5. Body Mass Index (Manage Weight)

Weight in kilograms divided by height in meters squared

Optimal: BMI <25 kg/m² (general population)

Note: Lower thresholds for Asian populations (BMI <23 kg/m²)

6. Blood Lipids (Control Cholesterol)

Non-HDL cholesterol (total cholesterol minus HDL cholesterol)

Optimal: Non-HDL-C <130 mg/dL without medication

7. Blood Glucose (Manage Blood Sugar)

Hemoglobin A1c (HbA1c) or fasting plasma glucose

Optimal: HbA1c <5.7% without diabetes medication or fasting glucose <100 mg/dL

8. Blood Pressure (Manage Blood Pressure)

Systolic and diastolic blood pressure

Optimal: <120/80 mmHg without medication

How Your Health Score is Calculated

Each of the 8 components is scored from 0-100 points using specific algorithms. Your overall Health Score is the average of all 8 component scores.

High Cardiovascular Health

80-100

Excellent cardiovascular health with optimal levels across most or all metrics

Moderate Cardiovascular Health

50-79

Room for improvement with targeted interventions on specific components

Low Cardiovascular Health

0-49

Significant cardiovascular health challenges requiring comprehensive intervention

Evidence: Higher Life's Essential 8 scores are strongly associated with lower risks of cardiovascular disease, all-cause mortality, and cardiovascular mortality. Each 13-point increase in LE8 score is associated with approximately 35% lower CVD risk.

Why Your Health Score May Differ from CKM Stage or PREVENT Risk

You might notice that your Health Score is high (80+) while your CKM stage is 3 or 4, or your PREVENT 10-year risk is elevated. This is completely normal and happens because these tools measure different aspects of your cardiovascular health.

What Health Score (LE8) Measures:

  • Current behaviors and metrics: Diet, exercise, sleep, tobacco use, and current lab values
  • Optimizable factors: Things you can improve through lifestyle changes and medications
  • Present-day snapshot: How you're doing right now, not your history

What CKM Stage and PREVENT Risk Add:

  • Disease history: Past heart attacks, strokes, diabetes diagnosis, kidney disease—conditions that carry ongoing risk even when well-controlled
  • Advanced biomarkers: Coronary artery calcium (CAC) score, NT-proBNP, troponin, severe kidney dysfunction—markers of structural disease that LE8 doesn't measure
  • Age factor (PREVENT): Cardiovascular risk increases with age regardless of current health behaviors
  • Medication dependence: Being well-controlled on multiple medications shows good management but also indicates underlying disease burden

The Bottom Line: A high Health Score means you're doing an excellent job managing your cardiovascular health behaviors and current risk factors. Having an elevated CKM stage or PREVENT risk simply means you have additional factors (like age, disease history, or structural changes) that require ongoing medical management. This is why we use all three tools together—they give us a complete picture and help tailor your care plan.

How Your Health Score is Used in Porter Health

Your Porter Health dashboard calculates your Health Score based on your profile information, lab results, and lifestyle habits:

1

Comprehensive Assessment: We gather data across all 8 metrics from your intake questionnaire and lab results

2

Individual Scores: Each of the 8 components is scored 0-100 using AHA's official algorithms

3

Overall Score: Your overall Health Score is calculated as the average of all 8 components

4

Personalized Action Plan: We identify your lowest-scoring components and provide targeted recommendations to improve them

Scientific Evidence

Primary Source

Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146(5):e18-e43.

DOI: 10.1161/CIR.0000000000001078