About the National Data


Baseline: 3.2 was the mean cardiovascular health score (maximum score of 7.0) among adults aged 18 years and over in 2013-16

Target: 3.5 mean cardiovascular health score

Sum of cardiovascular health scores among non-pregnant adults aged 18 years and over.
Number of non-pregnant adults 18 years and over with available data on cardiovascular health scores.
Target-setting method

Percent improvement

Target-setting method details
10 percent improvement from the baseline.
Target-setting method justification
Trend data were not available for this objective. A 10 percent improvement from the baseline was used to calculate a target. This method was used because the target was a statistically significant improvement from the baseline. The target represents a notable improvement in the mean score and appreciates recent trends in the individual metrics within the composite score.


Methodology notes

A small percentage of US adults met the criteria for overall ideal cardiovascular health, based on a score of 5 or more out of 7 possible. Because small changes within this combined metric of risk factors and behaviors can result in significant population improvements in health, the mean score will be tracked over time.

7 metrics of cardiovascular health were assessed including: physical activity, diet, smoking, cholesterol, body mass index, blood pressure, and diabetes.

The American Heart Association (AHA) definition of ideal cardiovascular health metrics for adults was used as the template for analysis. Physical activity was assessed among those meeting current Physical Activity Guidelines for Americans (>150 minutes of combined moderate- and vigorous-aerobic physical activity). All NHANES examinees are eligible for two 24-hour dietary recall interviews. The first dietary recall interview is collected in-person in the Mobile Examination Center and the second interview is collected by telephone 3 to 10 days later. The dietary intake data are used to estimate the types and amounts of foods and beverages (including all types of water) consumed during 24-hour period prior to the interview (midnight to midnight), and to estimate intakes of energy, nutrients, and other food components from these foods and beverages. USDA Healthy Eating Index 2010 (HEI-2010) was derived from the 24-hour dietary recalls. National Cancer Institute (NCI) Macro is used to estimate the usual intake of HEI-2010 scores adjusting for age in years, gender, race-ethnicity, the first or second day dietary recalls, and the day of the week when 24-hour recall was collected (weekday [Monday–Thursday] vs. weekend [Friday–Sunday]). The first 24-hour dietary recall was used for categorization, with HEI-2010 scores of ≥81 out of a possible 100 considered healthy. The healthy diet score from the USDA HEI-2010 ranges from 0 to 100 and is calculated by summing the following 12 components: total fruit; whole fruit; total vegetables; grains and beans; whole grains; dairy; total protein foods; seafood and plant protein; fatty acid; refined grains; sodium; and empty calories. The ideal category of smoking status included those who never smoked and those former smokers who had not smoked for 12 months or longer. Total cholesterol is a combination of high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL). Total blood cholesterol is measured enzymatically in a series of coupled reactions. A description of the procedures for the total cholesterol measurement in NHANES has been published by NCHS. Blood cholesterol levels less than 200 mg/dL are considered desirable. Levels of 240 mg/dL or above are considered high. Levels of 200-239 mg/dL are considered borderline. Use of cholesterol-lowering medications were used. The average of up to 3 blood pressure measurements were used to assess blood pressure status. Fasting plasma glucose values were available for a subsample of NHANES participants; we presented the prevalence of fasting plasma glucose levels but used glycated hemoglobin (HbA1c) values less than 5.7% as a proxy for fasting glucose levels less than 100 mg/dL (to convert to mmol/L, multiply by 0.0555). Alcohol consumption was defined as 0, <2, or ≥2 drinks daily for men, and 0, <1, or ≥1 drinks daily for women. We constructed a cardiovascular health metrics score (number of cardiovascular health metrics) by recoding the 7 metrics as dichotomous variables using 1 point for the AHA ideal category vs 0 points for the other categories: (never and former smoking [1 point] vs current smoking [0 points]) + (ideal physical activity [1 point] vs others [0 points]) + (body mass index [BMI, calculated as weight in kilograms divided by height in meters squared] <25 [1 point] vs others [0 points]) + (HEI-2010 ≥81 [1 point] vs <81 [0 points]) + (total cholesterol <200 mg/dL [to convert to mmol/L, multiply by 0.0259] untreated [1 point] vs others [0 points]) + (blood pressure <120/<80 mm Hg untreated [1 point] vs others [0 points]) + (HbA1c <5.7% [1 point] vs others [0 points]). All participants were classified as meeting 0, 1, 2, 3, 4, 5, 6, or 7 cardiovascular health metrics. The average of 7 cardiovascular health metrics was calculated.


Comparable HP2020 objective
Related, which includes objectives that have the same or a similar intent to either a measurable or developmental/archived objective in Healthy People 2020.