Fewer than 5% of U.S. military veterans may achieve optimal cardiovascular health based on the American Heart Association's Life's Essential 8™ metrics, according to a new scientific statement published today in the Association's flagship journal, Circulation. The statement, titled "Cardiovascular Health Promotion for U.S. Veterans: Current State, Gaps, and Strategies," is devoted specifically to promoting cardiovascular health among military veterans and highlights an urgent opportunity to improve prevention and help veterans live longer, healthier lives.
The Life's Essential 8 framework includes healthy eating, physical activity, avoiding tobacco use, healthy sleep, healthy weight, and healthy levels of blood sugar, cholesterol and blood pressure. According to the American Heart Association, around 20% of the general U.S. adult population may achieve optimal cardiovascular health, making the veteran population's cardiovascular health burden disproportionately high.
"Veterans are not simply older adults who happen to have served in the military. They are a diverse population with unique health risks shaped by their military service, chronic conditions, mental health, service-related exposures and barriers to care," said Neal Yuan, M.D., chair of the scientific statement volunteer writing group and assistant professor of medicine in the division of cardiology at the University of California San Francisco. "Recognizing how these factors interact and influence well-being is essential to providing effective prevention and treatment."
Military veterans represent more than 5% of the U.S. adult population and are increasingly diverse in race, ethnicity, age, gender and military experience. The statement identifies several factors that can affect their cardiovascular health, including multiple chronic health conditions such as obesity, high cholesterol, high blood pressure, heart disease, Type 2 diabetes, sleep disorders, chronic lung disease and chronic kidney disease. Mental health conditions such as anxiety, depression and posttraumatic stress disorder can each independently double the risk of major cardiovascular disease. Substance use disorder involving tobacco, alcohol or illicit drug use is linked to shortening lifespan by 6 to 24 years. Lower-quality diets and physical activity levels below recommendations, military-related injuries, environmental exposures, psychological stressors, and barriers to care including rural residence and limited internet connectivity also play a role.
The statement outlines practical opportunities to improve lifestyle behaviors, cardiometabolic health, mental health, substance use and sleep disorders among veterans. Strategies include expanding access to healthy foods and nutrition and weight-management programs, tailoring physical activity goals to veterans' abilities, improving screening and treatment for obesity, diabetes, high cholesterol and high blood pressure, expanding screening and support for mental health and substance use disorders while reducing stigma, increasing access to sleep disorder screening and treatment, and using telehealth and home-based tools such as at-home blood pressure monitoring to reach veterans who face barriers to in-person care.
Approximately 9 million veterans, nearly half of the U.S. military veteran population, are enrolled to receive care through the U.S. Department of Veterans Affairs, the nation's largest integrated healthcare system. The statement notes that VA programs addressing coordinated primary care, nutrition, physical activity, weight management, mental health, sleep, substance use and telehealth may offer models for other health systems. These include Patient Aligned Care Teams, which integrate primary care clinicians with pharmacists, dietitians, behavioral health professionals and other specialists, as well as MOVE! and Whole Health programs that support healthy eating, physical activity and weight management.
"The VA provides no- or low-cost comprehensive medical care, as well as housing and social work resources," Yuan said. "The health system has invested in and developed innovative programs to improve cardiovascular health in the veteran population that have been successful in delivering high-quality care."
The American Heart Association also supports veterans through its Women Veterans and Heart Health initiative, which provides resources focused on the distinctive health risks of women who have served in the armed forces. "This scientific statement shines an important light on the disproportionate burden of cardiovascular disease among those who serve or have served our country," said Mariell Jessup, M.D., chief science and medical officer of the American Heart Association. "By better understanding their unique risks and experiences, we can raise awareness, strengthen prevention and help more service members and veterans live longer, healthier lives."
The statement's findings have significant implications for veterans, their families, clinicians and policymakers. With fewer than 5% of veterans achieving optimal cardiovascular health, there is a clear need for a comprehensive, whole-person approach that addresses lifestyle factors, metabolic health, mental health, sleep and social factors together. For more information, the manuscript will be available online after November 11, 2026, and additional resources include the American Heart Association News story "Veterans' unique heart-health risks call for personalized care" and a Spanish news release. The Association's financial information is also available.
