Abstract P139: Healthy Lifestyle Status, Antihypertensive Treatment and the Risk of Heart Failure among Finnish Men and Women

Abstract

Background: It is unclear which is more effective in preventing heart failure (HF) in hypertensive people: lifestyle intervention or antihypertensive drug treatment. Aim: To investigate whether there are differences in HF risk among hypertensive patients using antihypertensive drug treatment versus those engaging in a healthy lifestyle at baseline. Methods: Study cohorts included 38075 Finnish participants who were 25 to 74 years of age and free of HF at baseline. The study population was classified into five groups according to their blood pressure status at baseline. A healthy lifestyle was defined as having two or more healthy lifestyle factors including moderate or high level of physical activity, never smoking, body mass index <25 kg/m 2 , and vegetable consumption ≥3 times/week. Results: During a median follow-up of 14.1 years, 638 men and 445 women developed HF. Compared with normotensive people, hypertensive patients with and without antihypertensive treatment had a higher risk of HF. Engaging in a healthy lifestyle was associated with a decreased risk of HF. The multivariable-adjusted hazard ratios (HRs) of HF in the ten subgroups (normotensive group with a healthy lifestyle; hypertensive, unaware, untreated group with a healthy lifestyle; hypertensive, aware, untreated group with a healthy lifestyle; hypertensive, treated, controlled group with a healthy lifestyle; hypertensive, treated, uncontrolled group with a healthy lifestyle; normotensive group without a healthy lifestyle; hypertensive, unaware, untreated group without a healthy lifestyle; hypertensive, aware, untreated group without a healthy lifestyle; hypertensive, treated, controlled group without a healthy lifestyle; and hypertensive, treated, uncontrolled group without a healthy lifestyle) were 1.00, 1.50, 1.54, 2.24, 1.91, 2.12, 2.68, 3.05, 2.27, and 3.21 (Ptrend <0.001), respectively. Hypertensive subjects who used antihypertensive drugs but did not engage in a healthy lifestyle had a significantly higher risk of HF (HR 2.10; 95% CI 1.68–2.63) than hypertensive subjects who did not use antihypertensive drug but engaged in a healthy lifestyle. Hypertensive subjects who did not use antihypertensive drugs and did not engage in a healthy lifestyle had a significant higher risk of HF (HR 1.44; 95% CI 1.16–1.80) compared with hypertensive subjects who used antihypertensive drug and engaged in a healthy lifestyle. Conclusions: The present study demonstrates that the risk of HF was lower in hypertensive patients who engaged in a healthy lifestyle but higher in hypertensive people despite of antihypertensive drug treatment and adequate control of hypertension. Lifestyle intervention may be more effective in preventing HF than antihypertensive treatment in hypertensive subjects.