Statistically, the prevalence of heart failure increases with age, but a new prospective study is validating what holistic physicians have known for years: that a healthy lifestyle can markedly reduce the risk.
In a cohort of 20,900 apparently healthy men (mean age 54 years) from Physicians’ Health Study I, incidence of new onset heart failure was tracked over a mean of 22 years follow-up. Of the entire cohort, 5.7% of the men developed heart failure during the study period. Healthy behaviors associated with lower risk of heart failure included regular exercise, moderate alcohol intake, maintenance of normal body weight, not smoking, consumption of breakfast cereals, and consumption of fruits and vegetables.
The estimated lifetime risk of heart failure was lowest (10.1%) in men with 4 or more of these beneficial lifestyle habits and highest (21.2%) in men with none of these habits (Djoussé L, et al. JAMA 2009 Jul 22;302(4):394).
The findings met DynaMed’s criteria for Level 2 evidence. They were not ranked as Level 1 evidence because the reliability of the evidence is somewhat limited by the study’s cohort design. The prevalence of hypertension at baseline was highest in the group with no healthy habits (28.6%) and lowest in the group with 4 or more healthy habits (19.2%). Although a similar benefit from healthy habits was noted in separate analyses of men with and without hypertension, potential biases on the overall results related to these group differences cannot be excluded.
Still, the findings underscore the vast potential of lifestyle change in reducing the burden of chronic disease. In the same week the Djoussé study was published, the New England Journal of Medicine ran an editorial on healthcare reform calling for more investment in controlled trials comparing effectiveness of changes in lifestyle factors versus use of medications for prevention and treatment of medical illness (N Engl J Med 2009 Jul 23).
This article was reprinted from the DynaMed Weekly Update – Volume 4 Issue 30, July 28, 2009. DynaMed, published by EBSCO Publishing (www.ebscohost.com) is a commercial-free clinical reference tool created by physicians for physicians and other health care professionals for use primarily at the ‘point-of-care.’ Offering clinically-organized summaries for more than 3,000 topics, DynaMed is updated daily and monitors an extensive collection of journals and evidence review sources for high-quality research (www.ebscohost.com/dynamed/sources.php). The new evidence is then integrated with existing content, and overall conclusions are changed as appropriate representing a synthesis of the best available evidence.
For more information on heart failure in men, see the Heart failure prevention topic in DynaMed under Other Heart Failure Prevention Measures—Lifestyles.
