A scientific statement from the American Heart Association, published in its flagship journal Circulation, quietly measures a gap that many Americans have long sensed but rarely counted: only about one veteran in twenty may reach optimal heart health, while roughly one in five adults in the general population can. The document treats veterans not as a uniform group of older men but as a varied population whose hearts are shaped by service, chronic illness, mental strain, exposures and distance from care. Its authors, led by a University of California San Francisco cardiologist, argue that the
Fewer Than 5% of U.S. Veterans May Reach Optimal Heart Health, New AHA Statement Warns
Veterans are not simply older adults who happen to have served.
Mark
Fewer than 5% of veterans at optimal heart health. Why does that number land so hard?
Mimi
Because the general adult figure is already low, about 20%, and veterans fall far below it. That's the gap the statement is built around.
Mark
What's driving it?
Mimi
Not one thing. Chronic conditions, PTSD, depression and anxiety, substance use, injuries, exposures, and rural distance from care all stack up. Yuan's point is that veterans aren't just older adults.
Luke
I'd flag the wording, though. It says fewer than 5% "may" reach optimal health. That's hedged, and the source doesn't say what data produced the estimate.
Mimi
Fair. The statement is a synthesis of the current state, and the number is framed as a likelihood rather than a fresh count.
Mark
The mental health piece stood out to me.
Mimi
Each of those conditions can independently double the risk of major cardiovascular disease. That ties the heart to things cardiology doesn't usually screen for.
Luke
And the 6 to 24 years of lost lifespan from substance use is a wide range. It's reported as a linkage, not a precise effect for veterans.
Mark
Does the VA come out looking good?
Mimi
It's held up as a promising model: care teams, MOVE!, Whole Health, telehealth. About 9 million veterans are enrolled.
Luke
Notice, though, that the statement says these may offer models. The source doesn't give outcome data showing they close the gap, and the other half of veterans aren't in VA care.
Der Puls
- Fewer than 5% of U.S. veterans may reach optimal cardiovascular health, against roughly 20% of the general adult population.
- Anxiety, depression and PTSD can each independently double the risk of major cardiovascular disease, and substance use can cut lifespan by 6 to 24 years.
- Rural residence and weak internet access leave many veterans far from the in-person care that heart prevention usually demands.
- The AHA is pressing clinicians, researchers and policymakers to treat lifestyle, metabolic, mental health and sleep needs together rather than one at a time.
- Telehealth, home blood pressure monitoring and VA-style coordinated teams are offered as tools, with the open question of whether health systems beyond the VA will adopt them.
A scientific statement from the American Heart Association, published in its flagship journal Circulation, quietly measures a gap that many Americans have long sensed but rarely counted: only about one veteran in twenty may reach optimal heart health, while roughly one in five adults in the general population can. The document treats veterans not as a uniform group of older men but as a varied population whose hearts are shaped by service, chronic illness, mental strain, exposures and distance from care. Its authors, led by a University of California San Francisco cardiologist, argue that the answer lies in caring for the whole person, and they point toward the Department of Veterans Affairs as a source of lessons that other health systems might learn from.
A new scientific statement from the American Heart Association puts a stark figure on veterans' heart health: fewer than 5% may reach optimal cardiovascular health, compared with about 20% of the general adult population. Published in Circulation, the document is the first the Association has devoted specifically to veterans, and it applies its Life's Essential 8 framework alongside mental health and substance use.
The volunteer writing group was chaired by Neal Yuan, M.D., of the University of California San Francisco. He cautions that veterans are not simply older adults who once served; they are a diverse group, more than 5% of U.S. adults, whose risks are shaped by military life, chronic disease, psychological strain, exposures and barriers to care. Many carry several chronic conditions at once, and anxiety, depression and PTSD each raise cardiovascular risk substantially. Rural distance and limited connectivity make it harder still to get help.
The proposed responses are practical: better access to nutrition and weight programs, activity goals suited to each person, stronger screening for common conditions, more support for mental health and substance use without stigma, and attention to sleep. Telehealth and home blood pressure tools aim to reach those who cannot easily travel.
The Department of Veterans Affairs, which serves about 9 million enrolled veterans, is presented as a possible model. Its coordinated primary care teams, MOVE! and Whole Health programs, and telehealth services offer lessons others might borrow. Yuan argues that veterans and their families can use Life's Essential 8 to track key measures and set goals with a clinician. Mariell Jessup, M.D., the AHA's chief science and medical officer, underlined the heavy toll on those who serve. What remains to be seen is whether systems outside the VA take up these approaches.
A new scientific statement from the American Heart Association puts a stark number on the heart health of America's military veterans: fewer than 5% may reach optimal cardiovascular health. The statement was published in Circulation, the Association's flagship journal. By comparison, the AHA says around 20% of the general U.S. adult population may achieve that level.
The document is titled "Cardiovascular Health Promotion for U.S. Veterans: Current State, Gaps, and Strategies." It is the first of its kind to focus specifically on veterans, according to its framing as a statement devoted to that group. It uses the AHA's Life's Essential 8 framework, which covers healthy eating, physical activity, avoiding tobacco, healthy sleep, healthy weight, and healthy blood sugar, cholesterol and blood pressure. It also adds mental health and substance use to the picture, then lays out strategies for clinicians, researchers and policymakers.
Neal Yuan, M.D., chaired the volunteer writing group. He is an assistant professor of medicine in the division of cardiology at the University of California San Francisco. "Veterans are not simply older adults who happen to have served in the military," he said, describing instead a diverse population whose risks are shaped by service, chronic illness, mental health, exposures and barriers to care. Veterans make up more than 5% of U.S. adults and are increasingly varied in race, ethnicity, age, gender and military experience.
The statement lists the factors that weigh on veterans' hearts. Many have multiple chronic conditions, including obesity, high cholesterol, high blood pressure, heart disease, Type 2 diabetes, sleep disorders, chronic lung disease and chronic kidney disease. Anxiety, depression and posttraumatic stress disorder can each independently double the risk of major cardiovascular disease. Substance use disorder involving tobacco, alcohol or illicit drugs is linked to a shortened lifespan of 6 to 24 years. Veterans also tend toward lower-quality diets and less physical activity than recommended, and face military-related injuries, environmental exposures and psychological stressors. Rural residence and limited internet connectivity add barriers to getting care.
The proposed remedies are practical. They include wider access to healthy food, nutrition and weight-management programs; physical activity goals tailored to each veteran's abilities and resources; and better screening, prevention and treatment for obesity, diabetes, high cholesterol and high blood pressure. The statement also calls for more screening and support for mental health and substance use disorders, including tobacco use, while reducing the stigma of seeking care, and for greater access to sleep disorder screening and treatment. Telehealth and home-based tools, such as at-home blood pressure monitoring, are meant to reach veterans who cannot easily get to in-person appointments.
The Department of Veterans Affairs figures prominently as a possible model. About 9 million veterans, nearly half of the veteran population, are enrolled in VA care, which Yuan described as providing no- or low-cost comprehensive medical care along with housing and social work resources. The statement notes that VA programs in coordinated primary care, nutrition, physical activity, weight management, mental health, sleep, substance use and telehealth may offer lessons for other health systems. Among them are Patient Aligned Care Teams, which bring primary care clinicians together with pharmacists, dietitians, behavioral health professionals and other specialists; the MOVE! and Whole Health programs for healthy eating, activity and weight; and telehealth programs for diabetes, blood pressure, sleep and rural specialty care.
Yuan said improving veterans' heart health requires a whole-person approach that goes beyond traditional heart disease prevention, treating lifestyle, metabolic health, mental health, sleep and social factors together. He added that veterans and their families can use Life's Essential 8 to check key measures and discuss personalized goals with a health professional.
Mariell Jessup, M.D., the AHA's chief science and medical officer, said the statement highlights the disproportionate burden of cardiovascular disease among those who serve or have served. She pointed to the Association's Women Veterans and Heart Health initiative and its Military & Veterans Network Employee Resource Group. What to watch next is whether health systems outside the VA take up its coordinated-care and telehealth approaches.
Bemerkenswerte Zitate
Improving cardiovascular health among veterans requires a comprehensive, whole-person approach that goes beyond traditional heart disease prevention.— Neal Yuan, M.D., University of California San Francisco
The statement shines an important light on the disproportionate burden of cardiovascular disease among those who serve or have served.— Mariell Jessup, M.D., American Heart Association
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