New research gives important clues on how to protect heart health.
This is the main takeaway of a study which now appears in the journal JAMA Network Open.
Using the best evidence available, the American Heart Association (AHA) developed the so-called Life's Simple 7 — a collection of factors that can help predict and protect a person's heart health.
"Life's Simple 7" consists of four "modifiable behaviors" — that is, things you can do to lower your chances of developing heart diseases. These are: quitting smoking, maintaining a healthy weight, eating healthfully, and being physically active.
The AHA also includes three measures: blood pressure, cholesterol, and blood sugar. Keeping these in check, suggest the AHA, and following the four behaviors above reduces the risk of dying from stroke or cardiovascular disease (CVD).
The AHA suggest assessing each metric and behavior and grading them as "poor," "intermediate," and "ideal." So, the AHA would deem a behavior such as smoking regularly as "poor," having smoked in the past year as "intermediate," and quitting smoking or not smoking at all as "ideal."
"Only about 2% of people in the United States and other countries meet all the ideal requirements for these seven factors," explains Dr. Xiang Gao, who is an associate professor of nutritional sciences and director of the Nutritional Epidemiology Lab at Pennsylvania State University.
Dr. Gao is the last and corresponding author of the new study, which aimed to see if sticking to these seven steps over time will lower a person's future risk of CVD.
The fact that so few people meet AHA's criteria, Dr. Gao continues, "raises the question of whether improving these metrics is related to lower future risk of CVD. It should, but no one had the data to support this idea."
To find out, Dr. Gao and team examined data from 74,701 Chinese adults who took part in the Kailuan Study. The study participants answered questionnaires about their overall health and took part in various clinical tests three times between 2006 and 2010.
The researchers gathered this information and analyzed how it related to the incidence of CVD in the following years.
In 2006–2010, the researchers identified five heart health patterns that the study participants followed. "[A]bout 19% of participants were able to maintain a better cardiovascular health score over the 4 years," reports Dr. Gao.
"We found that those people had a 79% lower chance of developing heart disease in the future than people who maintained a low cardiovascular health score."
The researchers say that they obtained the same results when they looked at stroke and heart attack risk.
"We also examined whether improving cardiovascular health score over time affected future risk of CVD," Dr. Gao continues.
"We found that improvement of overall cardiovascular health over time related to lower future CVD in this population, even for those with poor cardiovascular health status at the beginning of the study."
Dr. Xiang Gao
Finally, the researchers also ran several tests repeatedly, each time removing one of the seven health factors. They did so to see if one health factor was more important than the others, but found no significant difference in risk prediction when they removed a single measure.
"This suggests that overall cardiovascular health is still the most important thing and that one factor isn't more important than the others," Dr. Gao says. "It also helps confirm that these seven metrics are valid and a very useful tool for developing a strategy for cardiovascular disease prevention."