Heart Health in 2026: Understanding Life's Essential 8

With February being American Heart Month, I want to take this opportunity to talk about something that affects nearly every family I see in my practice: heart disease. As the leading cause of death in the United States, cardiovascular disease touches millions of lives each year. The good news is that we now have a clear, evidence-based framework for protecting your heart—and it's never too late to start.

Why Heart Health Matters More Than Ever

In my practice, I see patients of all ages who are concerned about their heart health. Many of my patients are surprised to learn that heart disease doesn't just affect older adults—the foundations of cardiovascular health are built throughout our lives. The choices we make in our 20s, 30s, and 40s significantly impact our heart health decades later.

Here's a statistic that often surprises my patients: only 1 in 5 Americans has optimal cardiovascular health. That means the vast majority of us have room to improve—and improvement is absolutely possible with the right approach.

Understanding Life's Essential 8

In 2022, the American Heart Association updated their guidelines to introduce "Life's Essential 8"—a comprehensive framework for cardiovascular health. This replaces the previous "Life's Simple 7" and adds sleep as a crucial component. I find this framework incredibly helpful because it gives us specific, measurable goals to work toward.

Life's Essential 8 is divided into two categories: health behaviors (the actions we take) and health factors (the measurements we monitor). Let me walk you through each one.

The Four Health Behaviors

1. Eat Better

Many of my patients feel overwhelmed by conflicting nutrition advice. I keep it simple: focus on whole foods. This means plenty of fruits, vegetables, lean protein, nuts, seeds, and non-tropical oils like olive and canola oil. The goal is to eat foods that are as close to their natural state as possible.

I tell my patients that you don't need to be perfect—small improvements add up. Adding one extra serving of vegetables to your dinner, choosing whole grains over refined ones, or swapping out sugary drinks for water are all meaningful steps toward better heart health.

2. Be More Active

The American Heart Association recommends at least 150 minutes of moderate-intensity activity per week, or 75 minutes of vigorous activity. That works out to about 30 minutes a day, five days a week—and it doesn't have to happen all at once.

When patients tell me they don't have time for exercise, I remind them that movement counts in all its forms. Taking the stairs, walking during lunch breaks, gardening, or playing with your children all contribute to your weekly activity. The most important thing is finding movement you enjoy so you'll stick with it.

3. Quit Tobacco

This one is non-negotiable for heart health. Tobacco use—including cigarettes, cigars, and e-cigarettes—dramatically increases your risk of heart disease. I want to emphasize that vaping is not a safe alternative; the American Heart Association recommends avoiding all inhaled nicotine products.

If you're struggling to quit, please don't be discouraged. Nicotine addiction is powerful, and most people need multiple attempts before successfully quitting. As your primary care physician, I can help you develop a cessation plan that works for your lifestyle, including discussing medication options if appropriate.

4. Get Healthy Sleep

This is the newest addition to the framework, and I'm glad it's finally getting the attention it deserves. Adults need 7-9 hours of quality sleep per night. Sleep affects everything from blood pressure regulation to hormone balance to our ability to make healthy food choices.

If you're consistently getting less than 7 hours of sleep, or if you wake up feeling unrefreshed, it's worth discussing with your doctor. Conditions like sleep apnea are common and treatable, and addressing them can significantly improve your cardiovascular health.

The Four Health Factors

5. Manage Weight

The American Heart Association recommends maintaining a BMI between 18.5 and less than 25. I understand that weight is a sensitive topic for many people, and I approach it with my patients from a place of support, not judgment.

What I emphasize is that even modest weight loss—5 to 10 percent of your body weight—can meaningfully improve your cardiovascular health. If you're struggling with weight management, please know that you're not alone, and there are more effective tools available today than ever before.

6. Control Cholesterol

When we talk about cholesterol, we're particularly focused on non-HDL cholesterol—this includes LDL ("bad") cholesterol and other harmful particles. High cholesterol often has no symptoms, which is why regular screening is so important.

If your cholesterol levels are elevated, lifestyle changes like diet and exercise can help. For some patients, medication may also be recommended. The key is knowing your numbers so we can create a plan together.

7. Manage Blood Sugar

We monitor blood sugar through a test called hemoglobin A1c, which shows your average blood sugar over the past 2-3 months. Elevated blood sugar—even before it reaches the level of diabetes—can damage blood vessels and increase heart disease risk.

Many of my patients are surprised to learn they have prediabetes. The encouraging news is that prediabetes can often be reversed with lifestyle changes, preventing progression to type 2 diabetes and protecting your heart in the process.

8. Manage Blood Pressure

The goal is to keep blood pressure below 120/80 mm Hg. High blood pressure is often called the "silent killer" because it typically causes no symptoms while damaging your blood vessels and heart over time.

I check blood pressure at every visit because it's one of the most important indicators of cardiovascular health. If your blood pressure is elevated, we can discuss lifestyle modifications and, if needed, medications to bring it under control.

How Primary Care Can Help

As your primary care physician, I'm here to partner with you on your heart health journey. Here's how we can work together on each of Life's Essential 8:

• Nutrition guidance: I can provide personalized dietary recommendations and refer you to a registered dietitian if needed.
• Activity planning: We can discuss safe ways to increase your physical activity based on your current fitness level and any health conditions.
• Tobacco cessation: I offer comprehensive support including counseling and medication options to help you quit.
• Sleep evaluation: We can assess your sleep quality and screen for conditions like sleep apnea.
• Weight management: I provide compassionate, evidence-based support for achieving and maintaining a healthy weight.
• Regular monitoring: I track your cholesterol, blood sugar, and blood pressure over time to catch any changes early.
• Medication management: When lifestyle changes aren't enough, I can prescribe and monitor medications to protect your heart.

Small Steps, Big Impact

I understand that looking at Life's Essential 8 can feel overwhelming. Please remember that you don't need to change everything at once. In fact, research shows that making one or two sustainable changes is more effective than trying to overhaul your entire lifestyle overnight.

Pick one area to focus on this month. Maybe it's adding a daily walk, or cooking one more meal at home each week, or setting a consistent bedtime. Once that change becomes a habit, you can add another. Over time, these small steps add up to significant improvements in your heart health.

This American Heart Month, I encourage you to think about your own cardiovascular health. If it's been a while since your last check-up, or if you have concerns about any of Life's Essential 8, I'd love to see you in my office. Together, we can create a plan that works for your life and helps protect your heart for years to come.