People who reach their mid-life years — ages 45 to 55 — without developing obesity, diabetes or high blood pressure tend to spend significantly more of their later years free of heart failure than do other people, a new study reports.

They also tend to live longer.

Yes, yes, these findings are not a huge surprise. Obesity, diabetes and high blood pressure are known risk factors for heart failure. But what is surprising — and impressive — say the authors of the new study, is the magnitude of the association that their research revealed.

They found that people who avoided those three particular risk factors by age 45 were up to 86 percent less likely to develop heart failure later in life than their  peers who had all three risk factors at that same age.

“These data underscore the importance of preventing the development of risk factors in mid-life for decreasing the public health impact of heart failure,” the researchers stress.

The study was published Monday in the Journal of the American College of Cardiology: Heart Failure.

A serious illness

Heart failure, a chronic condition that occurs when the heart is unable to pump enough blood to meet the body’s needs, affects an estimated 5.7 million Americans, according to the Centers for Disease Control and Prevention (CDC). About half of the people who are diagnosed with heart failure die within five years, and the condition is responsible for about one in nine deaths in the U.S. each year.

The lifetime risk of developing heart failure ranges from 20 percent to 45 percent, depending on gender and race. For example, blacks — particularly black men — are much more likely than whites to develop heart failure, and they tend to develop symptoms at an earlier age. 

Those symptoms, which include fatigue, shortness of breath, persistent cough, difficulty concentrating, and fluid retention around the ankles and feet, can significantly lower a person’s quality of life and are associated with an increased risk of depression, anxiety and other psychological problems.

Study’s details

For the new study, a team of researchers led by Dr. John Wilkins of the Northwestern University Feinberg School of Medicine, analyzed pooled data collected from more than 43,000 men and women who had participated in one of four long-term studies launched in the United States between 1948 and 1987.

About 19,000 of the studies’ participants had been assessed for heart disease at age 45, while the other 24,000 had been assessed at age 55.

The data from those assessments revealed that 53.2 percent of the participants did not have obesity, diabetes or high blood pressure at age 45, and 43.7 percent did not have any of the risk factors at age 55.  

By 2007-2008, heart failure had developed in almost 1,700 of the participants tested at age 45 and in almost 3,000 of those tested at age 55.

Longer lifespans

Wilkins and his colleagues then looked to see how well a diagnosis of obesity, diabetes and high blood pressure at middle age predicted heart failure. They found that, overall, people with none of those risk factors at the age of 45 had a 73 percent to 86 percent lower risk of later developing heart failure compared to those who had all three risk factors.

They also lived, on average, an additional three to 15 heart-failure-free years than people with one, two or three of the risk factors. 

The findings were the same for men and women — and for black and white participants. The trends were also similar for the people who had been assessed at age 55.

Of the three risk factors, diabetes appeared to have the strongest effect. The participants without diabetes at age 45 lived an average of about 9 years longer without heart failure than their peers with the disease, while those without diabetes at age 55 lived for an average of about 11 years longer.

A heart-healthy lifestyle

This study has several limitations. Most notably, each of the four studies that provided the data defined the incidence of heart failure slightly differently. The data also did not account for changes in the participants’ risk factors before or after their heart-disease assessments at middle age. 

Still, the findings appear to reinforce the well-established advice to follow a heart-healthy lifestyle — no matter what your age.

FMI: You’ll find an abstract of the study on the JACC: Heart Failure website, but the full paper is behind a paywall. For information about heart failure, including how to prevent it, go to the National Heart, Lung and Blood Institute’s website.