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Does a higher Life's Essential 8 heart health score predict longer life?

Answered November 2, 202610 sources

EvidenceAStrongGood randomized trials in people that agree, with no serious weaknesses. New studies are unlikely to change the answer.

Yes. Adults with high Life's Essential 8 scores lived longer: roughly 40 to 45% lower risk of death than those with low scores, and about 9 more years of life expectancy at 50 in one study.

Who it's for
Adults of any age wanting a gauge of heart health; less clear for Mexican American adults.
What to expect
Higher scores go with lower risk of death, in steady steps.
Watch out for
These studies show links, not proof that raising a score extends life.
Higher heart health scores go with lower risk of death

Each dot is the risk of death for people with a high score compared with a low score, and the line shows the range of likely values.

Higher heart health scores go with lower risk of death
ResultEstimate95% rangeReading
Meta-analysis, all causes of death0.540.43 to 0.69Clear improvement
Meta-analysis, heart-related death0.370.26 to 0.52Clear improvement
US adults, high score, all causes0.420.32 to 0.56Clear improvement
US adults, medium score, all causes0.60.51 to 0.71Clear improvement

Sources 1 Eur J Prev Cardiol, 2025; 3 BMC Med, 2023

Figure 2. Kaplan–Meier curves for cumulative all-cause and CVD-specific mortality by total scores of cardiovascular health metrics

Figure 2 from Association of the American Heart Association's new "Life's Essential 8" with…, BMC Med 2023. Licence: CC BY 4.0

Figure 3. Dose–response associations of cardiovascular metric scores with all-cause and CVD-specific mortality.

Figure 3 from Association of the American Heart Association's new "Life's Essential 8" with…, BMC Med 2023. Licence: CC BY 4.0

What guidelines say

The American Heart Association created Life's Essential 8. It scores diet, physical activity, nicotine exposure, sleep, body weight, blood fats, blood sugar and blood pressure from 0 to 100 and averages them5.

What the studies show

  • A review that pooled 34 studies (about 1.79 million adults aged 18 to 80, followed about 11.6 years) linked higher scores to a 46% lower risk of death from any cause than lower scores. The true effect could be anything from about 31% to 57% lower1. Heart disease deaths were 63% lower1.
  • A study following 19,951 US adults for a median of 7.6 years linked an intermediate score to a 40% lower risk of death than a low score, and a high score to a 58% lower risk. Deaths from heart disease were 64% lower with a high score3.
  • Two studies estimated years of life. At age 50, people with high scores had about 8.9 more years of life expectancy than people with low scores in a US study of 23,003 adults9. In a UK study of 135,199 adults, high scores went with 6.9 more disease-free years for men and 9.4 for women7.
  • Over 30 years, a study of 1,662 Finnish men found every 50-point rise in the total score (on a 0 to 800 scale) linked to 14% lower risk of death from any cause. Men in the top quarter had 60% lower risk of heart disease death than the bottom quarter10.
  • Meta-analyses A study that pools the results of several earlier studies into one overall estimate. It is usually the strongest kind of evidence. of the older "Life's Simple 7" version found the same pattern. Each extra ideal measure was linked to an 11% lower risk of death from any cause4,8.
  • These figures compare groups, so the gain for one person depends on how high their risk was to begin with.

Key studies

StudyWhoWhat it found
Review of 34 studies, 20251About 1.79 million adultsHigh scores linked to 46% lower death risk
Study following people, 2023319,951 US adultsHigh score linked to 58% lower death risk
Study following people, 2023923,003 US adultsHigh score linked to 8.9 more years at 50
Study following people, 20237135,199 UK adultsUp to 9.4 more disease-free years
Study following people, 2023101,662 Finnish men14% lower death risk per 50 points

What we don't know

  • Whether raising your own score adds years, since these studies only compare people who already differ. Healthier people may differ in other ways.
  • Whether the link holds equally across ethnic groups. It was not seen in Mexican American adults, and Hispanic and Asian groups need more research9.

Try it yourself: Heart health score

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Written by AI from the studies listed, without review by a clinician, and graded with the GRADE method. It can be wrong, so check the studies it cites. Education, not medical advice.