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Realizing the promise of Life’s Simple 7

Making smart changes in behavior prevents damage to healthy and not-so-healthy arteries.

Every day, you make dozens of health-related decisions that influence the long-term well-being of your heart and arteries, from what you put in your mouth to how often you move. These lifestyle choices, along with factors such as high blood pressure, high cholesterol, or diabetes, may promote plaque buildup inside your arteries. Over time, that plaque (which contains fat, fibrous tissue, and often calcium deposits) may block blood flow, setting the stage for a heart attack or stroke.

Risk factors and artery calcification

Using a form of imaging called coronary artery calcium (CAC) scanning, doctors can detect specks of calcium in the walls of the heart’s arteries and derive a score that corresponds to the risk of future heart disease. Recently, researchers used CAC scoring to find out whether making a few key behavior changes could have a concrete benefit for cardiovascular health even before overt signs of disease appear. They reported their findings in the March 2015 American Heart Journal.

The researchers ranked the heart health behaviors of 1,700 middle-aged men and women based on a tool from the American Heart Association (AHA) called Life’s Simple 7. The premise of the tool is that people of all ages can improve their cardiovascular health by making changes in a few basic areas. These include following a healthy diet; getting regular physical activity; maintaining good control of blood pressure, blood sugar, and cholesterol levels; keeping to an ideal weight; and not smoking. None of the people in the study fell into the ideal range for all seven metrics. Not surprisingly, however, those who ranked the highest in more areas showed less evidence of arterial calcification.

Life’s Simple 7

The American Heart Association developed the Life’s Simple 7 in 2010 as an easy way for people to understand and track their risk of having a stroke or heart disease. The goal is to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardio-vascular disease and stroke by 20% by the year 2020.

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Changes you can make

Target for ideal heart health


Stop smoking

Having never smoked, or having quit smoking for more than a year


Reduce blood sugar

Fasting blood glucose below 100 mg/dL


Control cholesterol

Total cholesterol of less than 200 mg/dL


Manage blood pressure

Blood pressure below 120/80 mm Hg


Lose weight

Body mass index (BMI) in the normal range (18.5–25)


Get active

At least 150 minutes of moderate exercise or 75 minutes of intense exercise per week


Eat better

A diet that includes fruit, vegetables, whole grains, low-fat dairy products, poultry, fish, and nuts and limits red meats and sugar

“The risk of future cardiovascular problems is substantially diminished in those people who are in the ideal category for each of these health behaviors and risk factors. So the message for moms and dads is to make sure your kids adopt healthy behaviors. For younger and older adults, do what you can to push yourself into the ideal range,” says Dr. Mark Creager, professor of medicine at Harvard Medical School and president-elect of the American Heart Association. Moving the needle from poor to ideal in any of these areas should lower your chances of having a heart attack or stroke.

A constellation of factors

When it comes to making changes, improving your heart health profile across the spectrum will net greater gains than trying to tease out one particular area. “If you take a step back, you can see how all these factors are interconnected,” says Dr. Creager. This is especially true when taking into account the ramifications of choices over many years. For example, he says, a young person may not yet have a problem with high blood pressure or diabetes. However, a poor diet early in life that includes too much salt or causes obesity can trigger these diseases—and lead to a higher cardiovascular risk later in life.

Who should have a CAC scan?

Right now, doctors don’t routinely advise everyone to have a coronary artery calcium scan. For people without known heart disease, the first step is to use a risk calculator developed by the AHA and the American College of Cardiology that projects a person’s chances of having a heart attack or stroke over the next 10 years (see If your 10-year risk is in a gray zone, your doctor may want to get more information by doing a CAC test to determine how aggressively to treat you. Clinical trials are currently under way to explore whether CAC testing may be appropriate for a broader range of individuals at different risk levels.

To calculate your personal score, get more information, and track your progress using AHA’s My Life Check tool, go to 

Image: Thinkstock

Posted by: Dr.Health

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