Healthy lifestyle choices may dramatically reduce heart attacks

A new study from Karolinska Institutet shows that following a healthy lifestyle, including maintaining a healthy weight and diet, exercise, not smoking and moderating alcohol intake, could prevent four out of five coronary events in men. The results are published in the well esteemed Journal of the American College of Cardiology.

“It is not surprising that healthy lifestyle choices would lead to a reduction in heart attacks, what is surprising is how drastically the risk dropped due to these factors”, saysAgneta Åkesson, Associate Professor at the Institute of Environmental Medicine, Karolinska Institutet, and lead author of the study. “While mortality from heart disease has declined in recent decades, with much of the reduction attributed to medical therapies, prevention through a healthy lifestyle avoids potential side effects of medication and is more cost effective for population-wide reductions in coronary heart disease.”

For the current study, researchers examined a population of 20,721 healthy Swedish men aged 45-79 years of age and followed them for 11 years. Lifestyle choices were assessed through a questionnaire exploring diet, alcohol consumption, smoking status, level of physical activity and abdominal adiposity (belly fat). Men in the study with the lowest risk were non-smokers, walked or cycled for at least 40 minutes per day, exercised at least one hour per week, had a waist circumference below 95 centimeters, consumed moderate amounts of alcohol, and followed a healthy diet with a regular consumption of fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains and fish.

Each lifestyle factor

The researchers found a clear reduction in risk for heart attack for each individual lifestyle factor the participants practiced.

“For instance having a low-risk diet together with a moderate alcohol consumption led to an estimated 35 percent lower risk of heart attack compared to the high-risk group, those who practice none of the low-risk factors”, says Agneta Åkesson. “Men who combined the low-risk diet and moderate alcohol consumption with not smoking, being physically active and having a low amount of abdominal fat, had 86 percent lower risk.”

According to the study-authors, the burden of cardiovascular disease could be significantly reduced through programs targeted to men, and promoting low-risk lifestyle choices could at best prevent four out of five coronary events in men. Even in men with higher cardiovascular risk, such as those with hypertension and high cholesterol levels, a reduction in risk was observed with increasing healthy behavior. Although it is of great importance that these factors are modifiable, extensive prevention can only be achieved through inhibiting the initiation and establishment of any high risk behavior already early in life.

The study has been funded by grants from FORTE and the Swedish Research Council.

Publication

Low-Risk Diet and Lifestyle Habits in the Primary Prevention of Myocardial Infarction in Men; A Population-Based Prospective Cohort Study
Agneta Åkesson, Susanna C. Larsson, Andrea Discacciati, Alicja Wolk
Journal of the American College of Cardiology (JACC), online 22 September 2014, VOL. 64, NO. 13, 2014