The results of two long-term studies strengthen the scientific evidence that maintaining a normal weight, eating healthfully, exercising regularly, drinking only in moderation, and not smoking can lower the risks of heart failure and high BP.

The first trial looked at a prospective cohort study using data from 20,900 men to assess lifetime risk of heart failure. Investigators evaluated six modifiable lifestyle factors: body weight, smoking, exercise, alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables (JAMA. 2009;302:394-400).

During an average follow-up of 22.4 years, 1,200 men developed heart failure. The highest lifetime risk for heart failure was seen in men complying with none of the six desirable lifestyle factors, and the lowest risk existed in men complying with four or more factors (21.2% vs. 10.1%).

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Lifetime risk was also higher in men with hypertension compared with those who were normotensive, a finding that dovetailed with a second report in the same issue (pages 401-411). In another prospective cohort study, investigators looked at the impact of six modifiable lifestyle and dietary factors on hypertension in 83,882 adult women (aged 27-44 years) in the second Nurses’ Health Study. The low-risk factors for hypertension were BMI <25; average of 30 minutes of vigorous exercise daily; adherence to the Dietary Approaches to Stop Hypertension diet; modest alcohol intake (<10 g/day); use of nonnarcotic analgesics less than once per week; and daily intake of at least 400 µg of folic acid.

None of the women had cardiovascular disease, diabetes, or cancer, and all had normal BP when the study began. After 14 years of follow-up, 12,319 new cases of hypertension developed. The risk of hypertension was about 80% lower for women who had all six low-risk factors than for other participants. BMI was the most powerful predictor of hypertension.

“Our data indicate that adherence to a combination of low-risk lifestyle factors could have the potential to prevent the majority of new-onset hypertension in young women irrespective of family history of hypertension and irrespective of oral contraceptive use,” the authors state.