The American Heart Association now includes sleep in its guidelines for Building Cardiovascular Health, publishing in the Circulation journal the updated and improved “Life’s Essential 8” list of rules for optimal heart and brain health, a powerful tool that promotes healthy aging and improved cardiovascular health, while reducing the risk of heart disease, stroke, cancer, dementia and many other chronic diseases.
“The new sleep duration variable reflects the latest scientific evidence: sleep affects overall health, and people with healthier sleep routines have better regulated health factors such as weight, blood pressure or risk of type 2 diabetes,” commented the Society’s president, Donald M. Lloyd-Jones, professor of Cardiac Research and preventive medicine and pediatrics at Northwestern University Feinberg School of Medicine, pointing out the contribution of technology with wearables and other portable devices that allow better monitoring and recording of sleep habits.
The eight components of optimal cardiovascular health are divided into two groups, health behaviors (diet, physical activity, nicotine exposure) and health factors [Body Mass Index (BMI), cholesterol levels, sugar, blood pressure]. The “Life’s Essential 8” advisory guide for ages 2 and up suggests:
- Diet: The ideal diet follows the logic of the DASD (Dietary Approaches to Stop Hypertension) diet, which is based on greater consumption of fruits, vegetables, nuts and legumes, whole grains, low-fat dairy and limited consumption and intake of sodium, red and processed meats and sugary drinks. The Mediterranean diet is a DASH diet.
- Physical activity: For now, the guidelines have not been revised and retain the gold standard of 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous exercise per week for adults, 420 minutes or more for children over 6 years of age, and special adaptation for younger children.
- Nicotine: The new guide includes, in addition to traditional cigarette smoking, electronic cigarettes (e-cigarettes) and vaping as potential long-term health threats, as well as passive smoking as a significant risk for children and adults.
- Sleep duration: According to the new addition to protect cardiovascular health, 7-9 hours of sleep per day is recommended for adults and for children 10-16 hours for 5 years and under, 9-12 hours for 6-12 years and 8-10 hours for 13-18 year olds.
- BMI: This index has specific characteristics and for Europeans it is considered healthy when it ranges between 18.5-24.9. However, it is not a general rule since its relationship with cardiovascular health is influenced by racial or ethnic origin. The World Health Organization e.g. specifically adjusts the BMI range for people of Asian descent in whom the greatest risk for conditions such as cardiovascular disease or type 2 diabetes begins at a lower BMI.
- Lipids: An update on the measurement of blood lipids (cholesterol, triglycerides), which is proposed not to measure total cholesterol – total below 200 mg/dl according to the previous guideline – but to leave out “good” HDL and to focus on the other forms such as “bad” LDL that increase cardiovascular risk.
- Blood Glucose: Measuring sugar now includes the option to measure glycated hemoglobin or blood glucose levels for each individual regardless of whether they have prediabetes or type 1 and 2 diabetes.
- Blood pressure: Optimal blood pressure levels remain the same, ie below 120/80 mm Hg, with hypertension defined as systolic pressure of 130-139 mm Hg and diastolic pressure of 80-89 mm Hg.
