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

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.U.S. Department of Health and Human Services | Centers for Disease Control and Prevention | MMWR | October 15, 2026 | Vol.75 | No. 1CVH-related behaviors decline as adolescents get older (1,7,8).Patterns in these behaviors and health factors also vary among racial and ethnic groups (1,4,7,8).These differences highlight the importance of examining CVH by sex, grade, and race and ethnicity.National public health priorities, including Healthy People 2030 (https://odphp.health.gov/healthypeople),emphasize improving nutrition, physical activity, sleep, and tobacco use outcomes among adolescents, aligning with the core metrics of CVH.The Youth Risk Behavior Surveillance System (YRBSS), the largest school-based surveillance system in the United States, provides data on these behaviors among high school students and includes nationally representative data as well as data from states, territories, tribal governments, and local school districts (9).This report analyzed data from the 2025 national Youth Risk Behavior Survey (YRBS), a component of YRBSS, to estimate five CVH metrics (diet, physical activity, nicotine exposure, sleep health, and BMI) and an overall CVH score among U.S. high school students.Differences in CVH metric scores and the overall CVH score were examined by sex, grade, and race and ethnicity.These findings are intended for public health practitioners, school and education professionals, researchers, and policymakers to guide efforts for monitoring CVH among adolescents and strengthen school and community policies and practices that support healthy behaviors. Methods Data SourceThis report includes data from the 2025 YRBS (N = 10,710), a cross-sectional, school-based survey conducted biennially since 1991.Each survey year, CDC collects data from a nationally representative sample of students from public and private schools, including parochial schools, in grades 9-12 in the 50 U.S. states and the District of Columbia.Additional information about YRBS sampling, data collection, response rates, and processing is available in the overview report of this supplement (9).The prevalence estimates for all YRBS variables among U.S. high school students overall and stratified by demographic characteristics are available at https:// youthonline.cdc.gov.The full YRBS questionnaire, datasets, and documentation are available at https://www.cdc.gov/yrbs/index. html.This study was approved by institutional review boards at CDC and ICF, the survey contractor, and was conducted consistent with applicable federal law and CDC policy.** 45 C.F.R. part 46.114; 21 C.F.