Four Factors Pump Up Heart Health

Coronary heart disease risk may be lowered through four lifestyle changes

/ Author:  / Reviewed by: Dominique Brooks, M.D

(RxWiki News) When it comes to having a healthy heart and preventing build up of calcium deposits in the arteries, diet, exercise, maintaining normal weight and not smoking can make a big difference.

The American Heart Association (AHA) already recommends maintaining a diet rich in vegetables, fruits, nuts, whole grains and fish, as well as keeping a BMI of less than 25, being physically active and not smoking.

New research confirms that these four factors—especially not smoking—have definite heart health benefits, including the early prevention of coronary calcium accumulation.

"Eat right, exercise and don’t smoke."

Haitham Ahmed, MD, an internal medicine resident with the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins Medicine in Baltimore, and his colleagues followed more than 6,200 men and women, age 44 to 84, from white, African-American, Hispanic and Chinese backgrounds.

Study participants all took part in the ongoing Multi-Ethnic Study of Atherosclerosis (MESA). Based on diet, exercise, body mass index, and smoking status, each was given a lifestyle score ranging from 0 (least healthy) to 4 (healthiest).

After an average of 7.6 years, scientists found that individuals who adopted all four healthy behaviors had an 80 percent lower death rate over that time period compared to participants with none of the healthy behaviors. Only 2 percent, or 129 participants, however, satisfied all four healthy lifestyle criteria.

When they were first enrolled, all subjects had a coronary calcium screening using computed tomography (a CT scan) to see if there were early signs of calcium deposits in their heart arteries that are known to contribute to heart attack risk.

Investigators observed that annual calcium progressions in participants were increasingly slower in relation to improved lifestyle scores.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRX News, "Calcium deposits are essentially a marker for cholesterol buildup. As cholesterol plaques mature and harden, they naturally become calcified over time. The coronary calcium screening test allows us to quickly and noninvasively assess for evidence of cholesterol buildup with a CT scanner."

As the study progressed, the researchers also assessed whether the participants had had heart attacks, sudden cardiac arrest, chest pain, angioplasty or died due to coronary heart disease or other causes.

The authors noted that a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance was associated with lower coronary calcium incidence and lower all-cause mortality.

"Of all the lifestyle factors, we found that smoking avoidance played the largest role in reducing the risk of coronary heart disease and mortality," said Roger Blumenthal, MD, a cardiologist and professor of medicine at the Johns Hopkins University School of Medicine, director of the Ciccarone Center and senior author of the study. "In fact, smokers who adopted two or more of the healthy behaviors still had lower survival rates after 7.6 years than did nonsmokers who were sedentary and obese.

In summing up the results, Dr. Ahmed concluded, "While there are risk factors that people can't control, such as their family history and age, these lifestyle measures are things that people can change and consequently make a big difference in their health."

Dr. Samaan added, "I think it always bears repeating that most heart disease is preventable. It doesn't take expensive supplements or severely restrictive diets to achieve a healthy heart. For most of us, not smoking, exercising regularly, eating a heart smart diet—like the Mediterranean diet and keeping body weight in a healthy range can make all the difference. By following these simple guidelines, we can not only reduce our risk of heart disease and stroke, but also cut health care costs and limit our need for prescription drugs. A win-win-win all around."

This study was posted online June 3, 2013 in the American Journal of Epidemiology.

This study was supported by the National Heart, Lung, and Blood Institute at the National Institutes of Health.

Reviewed by: 
Review Date: 
June 4, 2013
Last Updated:
August 7, 2013