Cardiovascular Health Among High School Students - Youth Risk Behavior Survey, United States, 2025.

Abstract

Monitoring cardiovascular health (CVH) among adolescents can identify opportunities for school and community programs to promote healthy behaviors and reduce cardiovascular disease risk. In this report, data from the nationally representative 2025 Youth Risk Behavior Survey (YRBS) of U.S. high school students were used to calculate scores for five metrics of CVH aligned with the American Heart Association's Life's Essential 8 framework: diet, physical activity, nicotine exposure, sleep health, and body mass index (BMI). Each of the five metrics assessed in this analysis was scored from 0 to 100, with higher scores indicating more favorable levels of the corresponding metric. The five metric scores were averaged to produce an overall CVH score, with higher scores indicating a more favorable overall CVH score. Weighted mean scores and the prevalence of high (80-100), moderate (50-79), and low (0-49) scores were estimated overall and by sex, grade, and race and ethnicity.Among 5,192 students with complete data, the mean overall CVH score was 65.3; 20.7% had high, 61.3% had moderate, and 18.0% had low overall CVH scores. For the CVH metrics, mean scores were highest for BMI (85.4, reflecting lower BMI) and nicotine exposure (80.5, reflecting lower exposure), and lowest for diet (39.3), sleep health (59.1), and physical activity (62.0). The overall CVH score was lower among female (64.2) than male (66.2) students. The overall CVH score was higher for grade 9 students (68.3) than for grade 10 (65.9), 11 (63.7), and 12 (62.7) students. Compared with most other racial and ethnic groups, the overall CVH score was higher among Asian students (70.2) and lower among Black or African American students (60.2). Similar demographic patterns were observed for the prevalence of high overall CVH scores.In 2025, approximately four in five U.S. high school students had a low or moderate overall CVH score, underscoring the importance of promoting healthy adolescent behaviors, such as healthy eating, sleep, and physical activity, to support healthier trajectories into adulthood. These findings highlight opportunities to monitor and improve CVH-related behaviors and indicators among adolescents, including within school and community settings.