Cited by 187Cardiovascular Health and Risk FactorsHeart Failure Treatment and ManagementCardiovascular Function and Risk Factors

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Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults

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Del Gobbo, Liana C., Kalantarian, Shadi, Imamura, Fumiaki, Lemaitre, Rozenn, Siscovick, David S., Psaty, Bruce M., Mozaffarian, Dariush·2015·JACC: Heart Failure

DOI 10.1016/j.jchf.2015.02.009PMC PMC4508377

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Abstract

OBJECTIVES: The goal of this study was to determine the relative contribution of major lifestyle factors on the development of heart failure (HF) in older adults. BACKGROUND: HF incurs high morbidity, mortality, and health care costs among adults ≥65 years of age, which is the most rapidly growing segment of the U.S. METHODS: We prospectively investigated separate and combined associations of lifestyle risk factors with incident HF (1,380 cases) over 21.5 years among 4,490 men and women in the Cardiovascular Health Study, which is a community-based cohort of older adults. Lifestyle factors included 4 dietary patterns (Alternative Healthy Eating Index, Dietary Approaches to Stop Hypertension, an American Heart Association 2020 dietary goals score, and a Biologic pattern, which was constructed using previous knowledge of cardiovascular disease dietary risk factors), 4 physical activity metrics (exercise intensity, walking pace, energy expended in leisure activity, and walking distance), alcohol intake, smoking, and obesity. RESULTS: No dietary pattern was associated with developing HF (p > 0.05). Walking pace and leisure activity were associated with a 26% and 22% lower risk of HF, respectively (pace >3 mph vs. <2 mph; hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.63 to 0.86; leisure activity ≥845 kcal/week vs. <845 kcal/week; HR: 0.78; 95% CI: 0.69 to 0.87). Modest alcohol intake, maintaining a body mass index <30 kg/m(2), and not smoking were also independently associated with a lower risk of HF. Participants with ≥4 healthy lifestyle factors had a 45% (HR: 0.55; 95% CI: 0.42 to 0.74) lower risk of HF. Heterogeneity by age, sex, cardiovascular disease, hypertension medication use, and diabetes was not observed. CONCLUSIONS: Among older U.S. adults, physical activity, modest alcohol intake, avoiding obesity, and not smoking, but not dietary patterns, were associated with a lower risk of HF.

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Authors: Del Gobbo, L. C., Kalantarian, S., Imamura, F., Lemaitre, R., Siscovick, D. S., Psaty, B. M., & Mozaffarian, D.
Affiliations: Harvard University (US)
University of Cambridge (GB)
University of Washington (US)
Group Health Cooperative (US)
Brigham and Women's Hospital (US)
ORCID: Kalantarian, Shadi
Imamura, Fumiaki
Siscovick, David S.
Psaty, Bruce M.
Mozaffarian, Dariush
Venue: JACC: Heart Failure
Publisher: Elsevier BV
Published: 2015-07
Volume: 3
Issue: 7
Pages: 520-528
ISSN: 2213-1779 (ISSN-L)
DOI: 10.1016/j.jchf.2015.02.009
PMC: PMC4508377
OpenAlex: W844777641
Cited by: 186
References: 33
Citations by year: 2026: 10 · 2025: 13 · 2024: 20 · 2023: 13 · 2022: 17 · 2021: 21 · 2020: 23 · 2019: 19 · 2018: 14 · 2017: 12 · 2016: 17 · 2015: 7
FWCI: 12.13
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor, 13 d)
Locations: JACC Heart Failure (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Apollo (University of Cambridge) (submittedVersion, cc-by)
Funders: National Heart, Lung, and Blood Institute (HL080295)
National Institute on Aging (AG023629)
Medical Research Council Unit Programme (MC_UU_125015/5)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: heart failure, older adults, lifestyle risk factors, physical activity, walking speed, leisure-time physical activity, alcohol consumption, smoking, obesity, dietary habits, healthy lifestyle, incident heart failure risk
MeSH terms: Aged, Alcohol Drinking, Diet, Female, Heart Failure, Humans, Male, Motor Activity, Obesity, Prospective Studies, Risk Factors, Smoking, United States, Cohort Studies, Incidence, Proportional Hazards Models, Sedentary Behavior

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Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults

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