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 in the Association’s flagship journal, Circulation. The statement, titled “Cardiovascular Health Promotion for U.S. Veterans: Current State, Gaps, and Strategies,” is the first to focus specifically on promoting cardiovascular health among military veterans. It applies the Life’s Essential 8 framework—which includes healthy eating, physical activity, avoiding tobacco use, healthy sleep, healthy weight, and healthy levels of blood sugar, cholesterol, and blood pressure—and additionally considers mental health and substance use. By comparison, the Association notes that around 20% of the general U.S. adult population may achieve optimal cardiovascular health.
“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.”
The statement identifies several factors affecting veterans’ cardiovascular health, including multiple chronic 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 like anxiety, depression, and posttraumatic stress disorder can independently double the risk of major cardiovascular disease, while substance use disorder involving tobacco, alcohol, or illicit drugs is linked to shortening lifespan by 6 to 24 years. Lower-quality diets, physical activity below recommendations, military-related injuries, environmental exposures, psychological stressors, and barriers to care—including rural residence and limited internet connectivity—further compound risk.
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 and resources, 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 facing 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 (VA), 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 (PACTs), which integrate primary care clinicians with pharmacists, dietitians, behavioral health professionals, and other specialists; MOVE! and Whole Health programs supporting healthy eating, physical activity, and weight management; and telehealth programs supporting diabetes management, blood pressure control, sleep health, and specialty care for veterans in rural areas.
“Improving cardiovascular health among veterans requires a comprehensive, whole-person approach that goes beyond traditional heart disease prevention,” Yuan said. “Addressing lifestyle factors, metabolic health, mental health, sleep and the social factors that influence health together can help veterans live longer, healthier lives.”
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, and its Military & Veterans Network Employee Resource Group. “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 was prepared by a volunteer writing group on behalf of several American Heart Association councils. The manuscript will be available manuscript online after November 11, 2026. Additional resources include a Spanish news release and Veterans’ unique heart-health risks call for personalized care.
