Lifestyle Factors in Relation to Heart Failure Among Finnish Men and Women

Abstract

Background— The role of lifestyle factors in explaining the risk of heart failure (HF) is not properly established. Methods and Results— The national population-based study included 18 346 Finnish men and 19 729 women who were 25 to 74 years of age and free of HF at baseline. Multivariable Cox proportional hazards regression models was used to examine the association between lifestyle factors (smoking, body mass index [BMI], physical activity, vegetable consumption, fruit consumption, and alcohol consumption) and HF risk. During a median follow-up of 14.1 years (interquartile range, 5.9 to 20.9 years), 638 men and 445 women developed HF. Fruit consumption and alcohol consumption were dropped out of the analyses because no significant associations with the risk of HF were found. When 4 modifiable lifestyle factors (smoking, BMI, physical activity, and vegetable intake) were included in the analysis, the multivariable-adjusted (age, education, systolic blood pressure, total cholesterol, and histories of myocardial infarction, valvular heart disease, diabetes and using antihypertensive drugs) hazard ratios (HRs) of HF associated with engaging in 0, 1, 2, 3, and 4 healthy lifestyle factors were 1.00, 0.69 (95% confidence interval [CI], 0.54 to 0.87), 0.45 (95% CI, 0.35 to 0.58), 0.34 (95% CI, 0.25 to 0.46), and 0.31 (95% CI, 0.17 to 0.56) ( P <0.001 for trend) for men, and 1.00, 0.53 (95% CI, 0.33 to 0.85), 0.42 (95% CI, 0.26 to 0.67), 0.24 (95% CI, 0.14 to 0.39), and 0.19 (95% CI, 0.09 to 0.40) ( P <0.001 for trend) for women, respectively. Conclusions— The present study demonstrates an inverse association between healthy lifestyle patterns and the risk of HF in Finnish men and women.