Lifestyle Factors and Risk of Heart Failure: A Prospective Cohort Study

Abstract

Heart failure (HF) has become a major health problem with its high prevalence, poor clinical outcomes, and large health-care costs. Compared with medical intervention, the prevention of HF through lifestyle approaches is free of side effect. Therefore, the prevention of HF through lifestyle approaches is of special interest. In this project, we aim to investigate 1) the association of different levels of occupational, commuting and leisure-time physical activity with HF risk; 2) the association of coffee consumption with HF risk; 3) the role of lifestyle factors in explaining the risk of HF; and 4) the association between antihypertensive drug treatment and HF risk with the association between engaging in a healthy lifestyle and HF risk. We conducted prospective studies among Finnish men and women who were 25 to 74 years of age and free of HF at baseline. Cox proportional hazards regression models were used to estimate the associations of interest. Partial population attributable risk was calculated to estimate the proportion of new HF cases occurring in this population that hypothetically could have been prevented if all subjects had certain health lifestyle factors. Our study results showed that 1) moderate and high levels of occupational or leisure-time physical activity are associated with a reduced risk of HF in both sexes; A simultaneous engagement in two or three types of physical activity showed a slightly stronger protective effect than participation in only one type of physical activity; 2) coffee consumption does not increase the risk of HF in Finnish men and women; In women, we observed an inverse association between low-to-moderate coffee consumption and the risk of HF; 3) maintaining a body mass index ¡Ü25, consuming vegetable ¡Ý3 times a week, abstaining from smoking and engaging in moderate or high level of physical activity were individually and jointly associated with a decreased risk of HF among both men and women; The relationship between the number of healthy lifestyle factors one engaged in and HF risk was dose-response; and 4) HF risk was lower in hypertensive patients who engaged in a healthy lifestyle but higher in hypertensive people using antihypertensive drug treatment.