Journal of American Medical Association, July 2009
Relation Between Modifiable Lifestyle Factors and Lifetime Risk of Heart Failure
The lifetime risk of heart failure at age 40 years is approximately 1 in 5 in the general population. However, little is known about the association between modifiable lifestyle factors and the remaining lifetime risk of heart failure.
To examine the association between modifiable lifestyle factors and the lifetime risk of heart failure in a large cohort of men, the researchers used data from 20 900 men (mean age at baseline, 53.6 years) from the Physicians' Health Study I (1982-2008) who were apparently healthy at baseline. Six modifiable lifestyle factors were assessed: body weight, smoking, exercise, alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables.
During a mean follow-up of 22.4 years, 1200 men developed heart failure. Overall, the lifetime risk of heart failure was 13.8% at age 40 years. Lifetime risk remained constant in men who survived free of heart failure through age 70 years and reached 10.6% at age 80 years. Lifetime risk of heart failure was higher in men with hypertension than in those without hypertension. Healthy lifestyle habits (normal body weight, not smoking, regular exercise, moderate alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables) were individually and jointly associated with a lower lifetime risk of heart failure, with the highest risk in men adhering to none of the 6 lifestyle factors and the lowest risk in men adhering to 4 or more desirable factors.
Conclusion: adherence to healthy lifestyle factors is associated with a lower lifetime risk of heart failure.
Diet and Lifestyle Risk Factors Associated With Incident Hypertension in Women
Hypertension is an important preventable risk factor for death among women. While several modifiable risk factors have been identified, their combined risk and distribution in the population have not been assessed. These researchers aimed to estimate the hypothetical fraction of hypertension incidence associated with dietary and lifestyle factors in women.
A study of 83 882 adult women aged 27 to 44 years in the second Nurses' Health Study who did not have hypertension, cardiovascular disease, diabetes, or cancer in 1991, and who had normal reported blood pressure, with follow-up for incident hypertension for 14 years through 2005. Six modifiable lifestyle and dietary factors for hypertension were identified. The 6 low-risk factors for hypertension were a body mass index (BMI) of less than 25, a daily mean of 30 minutes of vigorous exercise, a high score on the Dietary Approaches to Stop Hypertension (DASH) diet based on responses to a food frequency questionnaire, modest alcohol intake up to 10 g/d, use of nonnarcotic analgesics less than once per week, and intake of 400 µg/d or more of supplemental folic acid.
A total of 12 319 incident cases of hypertension were reported. All 6 modifiable risk factors were independently associated with the risk of developing hypertension during follow-up after also adjusting for age, race, family history of hypertension, smoking status, and use of oral contraceptives.
For women who had all 6 low-risk factors, the hazard ratio for incident hypertension was 0.22% of the population.
5 low-risk factors, 0.8% of the population
4 low-risk factors, 1.6% of the population
3 low-risk factors, 3.1% of the population
Body mass index alone was the most powerful predictor of hypertension.
Conclusion: adherence to low-risk dietary and lifestyle factors was associated with a significantly lower incidence of self-reported hypertension. Adopting low-risk dietary and lifestyle factors has the potential to prevent a large proportion of new-onset hypertension occurring among young women.