“Currently recommended risk models for CVD are harder for an individual to calculate on their own because they include clinical risk factors such as elevated cholesterol and blood pressure. These risk scores, which are mostly used in doctors’ offices, often underestimate the burden of CVD among middle-aged adults, and women in particular,” said Stephanie Chiuve, a research associate in the Department of Nutrition at HSPH and assistant professor in medicine at Harvard Medical School and Brigham and Women’s Hospital. “The Healthy Heart Score is all about modifiable lifestyle risks, which may increase awareness of CVD prevention through lifestyle interventions earlier in life, prior to the development of clinical risk factors.”
The study was published online November 14, 2014 in the Journal of the American Heart Association.
Despite being one of the leading causes of mortality and morbidity in the U.S. and globally, almost all CVD is preventable. Adults who remain free of clinical CVD risk factors when they are middle-aged have an extremely low risk of developing the disease for the rest of their life.
The model was developed using health data from 61,025 women in the Nurses’ Health Study and 34,478 men in the Health Professionals Follow-up Study, who were free of chronic disease in 1986 and followed for up to 24 years. During the study period, there were 3,775 cases of CVD (including nonfatal myocardial infarction, fatal coronary heart disease and ischemic stroke) in women and 3,506 cases in men.
The Healthy Heart Score is based on the nine most critical diet and lifestyle factors that can influence a person’s risk of developing CVD in the next 20 years: smoking, weight, exercise, and intake of alcohol, fruits and vegetables, whole grains, nuts, sugary beverages, and red and processed meat.
The calculator walks users through a series of easy-to-follow questions about their lifestyle, such as “Do you smoke cigarettes?” and “During the past year, how often, on average, do you eat a serving of fruit?” Users receive a risk score of low (green), moderate (yellow), or high (red), and a printable assessment with tips for improvement such as, “Instead of sliced deli turkey or chicken in sandwiches, try rotisserie chicken or roasted turkey,” and “Try a variety of nuts, including almonds, pistachios and cashews.”
“This tool represents the first time that data from large-scale, well-conducted studies were used to develop an easy-to-use CVD prevention tool,” said Eric Rimm, professor of epidemiology and nutrition at HSPH and senior author of the study.
Additional information on the role of diet and lifestyle factors for the prevention of CVD and other chronic diseases can also be found at HSPH’s Nutrition Source, www.thenutritionsource.org.
This study was funded by primarily by a Clinical Research Program Award from the American Heart Association. The Nurses’ Health Study is funded by CA87969, HL034594 and HL088521 and the Health Professionals Follow-up Study is funded by CA167552, CA055075 and HL35464 from the NIH. Chiuve is also supported by HL097068 from the National Institutes of Health.
“A lifestyle-based prediction model for the prevention of CVD: The Healthy Heart Score,” Stephanie E. Chiuve, Nancy R. Cook, Christina M. Shay, Kathryn M. Rexrode, Christine M. Albert, JoAnn E. Manson, Walter C. Willett, Eric B. Rimm, Journal of the American Heart Association, online Nov. 14, 2014, doi: 10.1161/JAHA.114.000954
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