Fewer than 2% of Americans meet seven recommended heart health targets that could dramatically reduce their risk of heart disease, according to a new study.

The research shows that the number of people who follow all seven heart-healthy habits recommended by the American Heart Association, like eating a healthy diet, being physically active, and having normal blood pressure, has actually declined in recent years.

Researchers found that the percentage of Americans who followed all of the health behaviors dropped from 2% in 1988-1994 to 1.2% in 2005-2010.

The seven behaviors include:

  • Not smoking
  • Being physically active
  • Having normal blood pressure (under 120/80)
  • Healthy fasting blood-glucose levels (below 100)
  • Total cholesterol levels below 200
  • Maintaining a healthy weight
  • Eating a healthy diet

People who met six of the seven goals had a 76% lower risk of heart-related death and a 51% lower risk of death from any cause, compared with those who met one or fewer.

Heart-Healthy Habits Lacking

In the study, published online in the Journal of the American Medical Association, researchers followed a group of nearly 45,000 adults who participated in the National Health and Nutrition Examination Survey from 1988-2010.

Not surprisingly, the results showed that the more heart-healthy goals people met, the lower their risk of heart disease and death. Meeting a higher number of the heart health targets was also associated with a lower risk of cancer.

Researchers found that younger people, women, whites, and people with higher education levels tended to meet more of the heart-healthy goals.

But despite increased public awareness of heart disease risk factors, researchers found some unhealthy trends.

For example, the number of people eating a healthy diet declined during the study period, and the prevalence of obesity and abnormal fasting blood-glucose levels increased.

In addition, the proportion of adults with healthy untreated blood pressure and total cholesterol levels remained unchanged from 1988 to 2010.

On the positive side, the percentage of current smokers dropped from 28% in 1988-1994 to 23% in 2005-2010, and the number of people who met the ideal heart-healthy level of physical activity increased from 41% to 45% during the same period.

But at the same time, the percentage of people classified as inactive, when it comes to physical activity, doubled from 16% to 32%.

More Work Needed to Target Majority at Risk

Experts say the results suggest new public health policies are needed to help the majority of people who are at moderate risk of heart disease and encourage them to follow more heart-healthy habits.

"With diseases such as [heart disease and stroke], the majority of events occur in the large proportion of the population with average or only mildly elevated levels of risk factors, rather than in the small subset with marked elevations," Donald M. Lloyd-Jones, MD, ScM, of the Northwestern University Feinberg School of Medicine, writes in an editorial that accompanies the study.

“Advocacy will be needed for new public health and social policies to tilt the playing field toward healthier choices, so more individuals can move from intermediate to ideal levels or maintain ideal [heart] health,” says Lloyd-Jones.

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