Middle-aged adults who achieve a good score on the American Heart Association’s Life’s Simple 7 checklist may be less likely to develop heart failure, according to a study published online ahead of print December 23, 2015, in Circulation: Heart Failure. The seven steps listed in the checklist are to manage blood pressure, control cholesterol, reduce blood sugar, become physically active, eat better, lose weight, and stop smoking.

Senior author Vanessa Xanthakis, PhD, and colleagues followed 3,201 individuals (average age, 59 years) for up to 12.3 years, finding that 188 developed heart failure. They found that a one-point increase in the Life’s Simple 7 checklist score was associated with a 23% lower risk of developing heart failure. Those with scores falling in the middle third of the range had a risk of heart failure that was lower by nearly one-half, compared to those scoring in the bottom third. Those in the top third had an even lower risk of heart failure.

The researchers also found an association between poor scores and cardiac remodeling (ie, changes in the heart’s structure and function), but after adjusting for cardiac remodeling, low scores still predicted heart failure. Limitations of the study were that most participants were white and of European ancestry, and scores were assessed only once at baseline, the authors said.