BACKGROUND:
A healthy lifestyle (not smoking, regular exercise, a healthy diet, and a healthy weight) has been shown to be associated with lower risk of coronary heart disease, stroke, and cardiovascular disease mortality. Little is known about the impact of a healthy lifestyle on risk of heart failure (HF).
OBJECTIVE:
To evaluate the effect of a combination of healthy lifestyle factors on incident HF.
METHODS:
Participants included 85,048 post-menopausal women from the Women’s Health Initiative (WHI) Observational Study, aged 50-79, who were free of HF at baseline and had a body mass index (BMI) ≥ 18.5 kg/m
2
. Lifestyle factors, assessed at baseline, were: Smoking (never, former, current), physical activity (inactive, somewhat active, active), Alternate Healthy Eating index (AHEI)- a composite numerical index of dietary quality, and BMI. A healthy lifestyle was defined by the following 4 criteria: never smoking, active, high-scoring AHEI (top 40% of the index), and a healthy weight (BMI < 25 kg/m
2
). Women received 1 point for every healthy lifestyle criterion met, with a possible range of 0-4 points. Self-reported HF was followed up by clinical adjudication using standardized methodology. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS:
There were 1826 cases of HF during a mean follow-up of 11 years. Individually, all 4 healthy lifestyle factors were significantly and independently associated with a decreased risk of HF, in a graded fashion (For example: HR = 0.68 {95% CI: 0.60,0.78} for active vs. inactive; HR=0.77 {95% CI: 0.68,0.88} for somewhat active vs. inactive). In analyses on the combination of healthy lifestyle factors, an increasing number of healthy lifestyle points was significantly associated with decreased risk of HF in multivariable-adjusted models (
Table
).
CONCLUSION:
Among a diverse US sample of post-menopausal women, an inverse and graded association was observed between number of healthy lifestyle factors and risk of HF.
Is Depression Associated with Incident Fractures in Post-Menopausal Women? Results from the Whi Observational Study
