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Healthy lifestyle status, antihypertensive treatment and the risk of heart failure among Finnish men and women

Wang, Yujiea,b,c; Tuomilehto, Jaakkod,e; Jousilahti, Pekkae; Antikainen, Riittaf; Mähönen, Markkud; Katzmarzyk, Peter T.a; Hu, Ganga

doi: 10.1097/HJH.0b013e328364136d

Objective: To compare the association between antihypertensive drug treatment and heart failure (HF) risk with the association between engaging in a healthy lifestyle and HF risk.

Methods: We prospectively investigated the single and joint associations of lifestyle factors and awareness, treatment, blood pressure control status with HF risk among 38 075 Finns, who were 25–74 years old and free of HF at baseline.

Results: During a median follow-up of 14.1 years, 638 men and 445 women developed HF. Engaging in a healthy lifestyle was associated with an decreased risk of HF. Compared with normotensive people, hypertensive patients with and without antihypertensive treatment had a higher risk of HF. Hypertensive patients who used antihypertensive drugs but did not engage in a healthy lifestyle had a significantly higher risk of HF [HR 1.75; 95% confidence interval (CI) 1.39–2.21] than hypertensive patients who did not use antihypertensive drugs but engaged in a healthy lifestyle. In addition, compared with hypertensive patients who used antihypertensive drugs and engaged in a healthy lifestyle, hypertensive patients who did not use antihypertensive drug or engage in a healthy lifestyle had a significantly higher risk of HF (HR 1.55; 95% CI 1.24–1.95).

Conclusion: The present study demonstrates that HF risk was lower in hypertensive patients who engaged in a healthy lifestyle but higher in hypertensive people using antihypertensive drug treatment.

aPennington Biomedical Research Center

bSchool of Human Ecology

cDepartment of Experimental Statistics, Louisiana State University, Baton Rouge, Louisiana, USA

dDepartment of Public Health, University of Helsinki

eDepartment of Health Promotion and Chronic Diseases Prevention, National Institute for Health and Welfare, Helsinki

fInstitute of Health Science, University of Oulu and Oulu City Hospital, Oulu, Finland

Correspondence to Dr Gang Hu, Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA. Tel: +1 225 763 3053; fax: +1 225 763 3009; e-mail:

Abbreviations: AHA, American Heart Association; CI, confidence interval; HF, heart failure; HR, hazard ratio; ICD, the International Classification of Diseases; MONICA, MONItoring trends and determinants of CArdiovascular disease; WHO, World Health Organization

Received 16 November, 2012

Revised 14 February, 2013

Accepted 10 June, 2013

A poster on part of the work was presented in Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions, San Diego, March 13-16, 2012.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins