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Healthy Lifestyle and Risk of Heart Failure: Results From 2 Prospective Cohort Studies.
Circ Heart Fail 2016; 9(4):e002855CH

Abstract

BACKGROUND

The joint impact of multiple healthy lifestyle factors on heart failure (HF) risk is unclear. We investigated the separate and collective associations of healthy lifestyle factors with HF incidence in 2 population-based prospective cohort studies.

METHODS AND RESULTS

This study consisted of 33,966 men (Cohort of Swedish Men) and 30,713 women (Swedish Mammography Cohort) who were 45 to 83 years of age and free of HF and ischemic heart disease at baseline. A healthy lifestyle was defined as being a nonsmoker and physically active (≥150 min/wk), and having body mass index between 18.5 and 25 kg/m(2) and a healthy diet (defined as adherence to a modified Mediterranean diet). Incident HF cases were ascertained by linkage with the Swedish National Patient Register and the Swedish Cause of Death Register. Cox proportional hazards regression was used to analyze the data. During 13 years of follow-up, HF was diagnosed in 1488 men and 1096 women. Each healthy lifestyle factor was associated with a statistically significant lower risk of HF in both men and women, and the risk decreased with increasing number of healthy behaviors. The greatest reduction in HF risk was observed for combinations that included nonsmoking. Compared with men and women with none of the healthy lifestyle factors, the multivariable relative risks (95% confidence interval) of HF for those with all 4 healthy behaviors were 0.38 (0.28-0.53) in men and 0.28 (0.19-0.41) in women.

CONCLUSIONS

Adhering to a healthy lifestyle is associated with a substantially lower HF risk.

CLINICAL TRIAL REGISTRATION

URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01127698 and NCT01127711.

Authors+Show Affiliations

From the Unit of Nutritional Epidemiology (S.C.L., T.G.T., A.A., A.W.) and Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine (B.G.), Karolinska Institutet, Stockholm, Sweden; and Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden (B.G.). susanna.larsson@ki.se.From the Unit of Nutritional Epidemiology (S.C.L., T.G.T., A.A., A.W.) and Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine (B.G.), Karolinska Institutet, Stockholm, Sweden; and Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden (B.G.).From the Unit of Nutritional Epidemiology (S.C.L., T.G.T., A.A., A.W.) and Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine (B.G.), Karolinska Institutet, Stockholm, Sweden; and Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden (B.G.).From the Unit of Nutritional Epidemiology (S.C.L., T.G.T., A.A., A.W.) and Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine (B.G.), Karolinska Institutet, Stockholm, Sweden; and Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden (B.G.).From the Unit of Nutritional Epidemiology (S.C.L., T.G.T., A.A., A.W.) and Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine (B.G.), Karolinska Institutet, Stockholm, Sweden; and Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden (B.G.).

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27072861

Citation

Larsson, Susanna C., et al. "Healthy Lifestyle and Risk of Heart Failure: Results From 2 Prospective Cohort Studies." Circulation. Heart Failure, vol. 9, no. 4, 2016, pp. e002855.
Larsson SC, Tektonidis TG, Gigante B, et al. Healthy Lifestyle and Risk of Heart Failure: Results From 2 Prospective Cohort Studies. Circ Heart Fail. 2016;9(4):e002855.
Larsson, S. C., Tektonidis, T. G., Gigante, B., Åkesson, A., & Wolk, A. (2016). Healthy Lifestyle and Risk of Heart Failure: Results From 2 Prospective Cohort Studies. Circulation. Heart Failure, 9(4), pp. e002855. doi:10.1161/CIRCHEARTFAILURE.115.002855.
Larsson SC, et al. Healthy Lifestyle and Risk of Heart Failure: Results From 2 Prospective Cohort Studies. Circ Heart Fail. 2016;9(4):e002855. PubMed PMID: 27072861.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Healthy Lifestyle and Risk of Heart Failure: Results From 2 Prospective Cohort Studies. AU - Larsson,Susanna C, AU - Tektonidis,Thanasis G, AU - Gigante,Bruna, AU - Åkesson,Agneta, AU - Wolk,Alicja, PY - 2015/11/26/received PY - 2016/03/07/accepted PY - 2016/4/14/entrez PY - 2016/4/14/pubmed PY - 2016/8/2/medline KW - diet heart failure hospitalization lifestyle prevention SP - e002855 EP - e002855 JF - Circulation. Heart failure JO - Circ Heart Fail VL - 9 IS - 4 N2 - BACKGROUND: The joint impact of multiple healthy lifestyle factors on heart failure (HF) risk is unclear. We investigated the separate and collective associations of healthy lifestyle factors with HF incidence in 2 population-based prospective cohort studies. METHODS AND RESULTS: This study consisted of 33,966 men (Cohort of Swedish Men) and 30,713 women (Swedish Mammography Cohort) who were 45 to 83 years of age and free of HF and ischemic heart disease at baseline. A healthy lifestyle was defined as being a nonsmoker and physically active (≥150 min/wk), and having body mass index between 18.5 and 25 kg/m(2) and a healthy diet (defined as adherence to a modified Mediterranean diet). Incident HF cases were ascertained by linkage with the Swedish National Patient Register and the Swedish Cause of Death Register. Cox proportional hazards regression was used to analyze the data. During 13 years of follow-up, HF was diagnosed in 1488 men and 1096 women. Each healthy lifestyle factor was associated with a statistically significant lower risk of HF in both men and women, and the risk decreased with increasing number of healthy behaviors. The greatest reduction in HF risk was observed for combinations that included nonsmoking. Compared with men and women with none of the healthy lifestyle factors, the multivariable relative risks (95% confidence interval) of HF for those with all 4 healthy behaviors were 0.38 (0.28-0.53) in men and 0.28 (0.19-0.41) in women. CONCLUSIONS: Adhering to a healthy lifestyle is associated with a substantially lower HF risk. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01127698 and NCT01127711. SN - 1941-3297 UR - https://www.unboundmedicine.com/medline/citation/27072861/Healthy_Lifestyle_and_Risk_of_Heart_Failure:_Results_From_2_Prospective_Cohort_Studies_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.115.002855?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -