Healthy lifestyle and decreasing risk of heart failure in women: the Women's Health Initiative observational study
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Authors
Agha, GolarehLoucks, Eric B.
Tinker, Lesley F.
Waring, Molly E.
Michaud, Dominique S.
Foraker, Randi E.
Li, Wenjun
Martin, Lisa W.
Greenland, Philip
Manson, JoAnn E.
Eaton, Charles B.
UMass Chan Affiliations
Prevention Research CenterDepartment of Medicine, Division of Preventive and Behavioral Medicine
Department of Quantitative Health Sciences
Document Type
Journal ArticlePublication Date
2014-10-28Keywords
AgedBody Mass Index
Body Weight
Feeding Behavior
Female
Heart Failure
Hospitalization
Humans
*Life Style
Middle Aged
Postmenopause
Prospective Studies
Risk Factors
Smoking
Women's Health
UMCCTS funding
Behavior and Behavior Mechanisms
Cardiology
Cardiovascular Diseases
Community Health and Preventive Medicine
Epidemiology
Health Services Research
Women's Health
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BACKGROUND: The impact of a healthy lifestyle on risk of heart failure (HF) is not well known. OBJECTIVES: The objectives of this study were to evaluate the effect of a combination of lifestyle factors on incident HF and to further investigate whether weighting each lifestyle factor has additional impact. METHODS: Participants were 84,537 post-menopausal women from the WHI (Women's Health Initiative) observational study, free of self-reported HF at baseline. A healthy lifestyle score (HL score) was created wherein women received 1 point for each healthy criterion met: high-scoring Alternative Healthy Eating Index, physically active, healthy body mass index, and currently not smoking. A weighted score (wHL score) was also created in which each lifestyle factor was weighted according to its independent magnitude of effect on HF. The incidence of hospitalized HF was determined by trained adjudicators using standardized methodology. RESULTS: There were 1,826 HF cases over a mean follow-up of 11 years. HL score was strongly associated with risk of HF (multivariable-adjusted hazard ratio [HR] [95% confidence interval (CI)] 0.49 [95% CI: 0.38 to 0.62], 0.36 [95% CI: 0.28 to 0.46], 0.24 [95% CI: 0.19 to 0.31], and 0.23 [95% CI: 0.17 to 0.30] for HL score of 1, 2, 3, and 4 vs. 0, respectively). The HL score and wHL score were similarly associated with HF risk (HR: 0.46 [95% CI: 0.41 to 0.52] for HL score; HR: 0.48 [95% CI: 0.42 to 0.55] for wHL score, comparing the highest tertile to the lowest). The HL score was also strongly associated with HF risk among women without antecedent coronary heart disease, diabetes, or hypertension. CONCLUSIONS: An increasingly healthy lifestyle was associated with decreasing HF risk among post-menopausal women, even in the absence of antecedent coronary heart disease, hypertension, and diabetes. Weighting the lifestyle factors had minimal impact. Elsevier Inc. All rights reserved.Source
J Am Coll Cardiol. 2014 Oct 28;64(17):1777-85. doi: 10.1016/j.jacc.2014.07.981.Link to article on publisher's site
DOI
10.1016/j.jacc.2014.07.981Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46686PubMed ID
25443698Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.jacc.2014.07.981
Scopus Count
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