Heart disease prevention tool shows promise


March 2, 2016 — Cardiovascular disease (CVD) is the leading cause of death in the U.S., and a healthy lifestyle is key to prevention. But the prevalence of healthy behaviors among U.S. adults is low. Current prevention strategies focus mainly on controlling CVD risk factors such as diabetes and hypertension with medication—as opposed to preventing them in the first place.

Now, new research from Harvard T.H. Chan School of Public Health suggests that a tool developed at the School two years ago—the Healthy Heart Score—could be a useful tool for doctors to promote healthy behaviors in their patients, according to lead author Mercedes Sotos-Prieto, Harvard Chan research fellow.

The Healthy Heart Score—which measures nine key lifestyle risk factors for CVD such as smoking, high body mass index, and low physical activity—is known to effectively predict the 20-year risk of CVD in adulthood. But it hasn’t been known if the score is also associated with CVD risk factors such as diabetes, hypertension, and hypercholesterolemia.

The new study shows that there is indeed a link. Researchers at Harvard Chan looked at 69,505 women participating in the Nurses’ Health Study II over a 20-year period and found that those with a higher predicted CVD risk based on the Healthy Heart Score (women in the highest quintile, as opposed to the lowest) also had significantly greater risk of developing diabetes (18-fold higher risk), hypertension (five-fold higher risk), and hypercholesterolemia (three-fold higher risk).

In addition, the researchers found that women with higher predicted CVD risk had a 53-fold greater risk of being diagnosed with all three CVD risk factors. This association was most pronounced among young women who didn’t smoke and weren’t overweight—suggesting that, even among women currently considered at low risk for CVD, other lifestyle factors may be involved in disease risk and that preventive measures should begin at a young age.

“Given that physicians have a limited amount of time to address disease prevention in their patients, the Healthy Heart Score could be used as a first step for CVD risk assessment and a catalyst for communication,” said Sotos-Prieto. “The Healthy Heart Score is an online tool that allows people to easily calculate their CVD risk through a series of questions about habits such as whether they smoke cigarettes or how often they eat fruit. This sort of tool could be useful even beyond the doctor’s office, such as in workplace wellness programs or community-based health fairs.”

Other Harvard Chan authors of the study included senior author Stephanie Chiuve, Josiemer Mattei, Frank Hu, Eric Rimm, Walter Willett, and Heather Eliassen.

Karen Feldscher