If you don’t smoke, aren’t overweight, get regular physical activity and eat vegetables, you can significantly reduce your risk for heart failure, according to research reported in Circulation: Heart Failure, an American Heart Association journal.

In a new study, people who had one healthy lifestyle behavior decreased their heart failure risk, and each additional healthy behavior further decreased their risk.

Heart failure affects about 5.7 million Americans. At age 40, a person’s lifetime risk of developing heart failure is one in five.

“Any steps you take to stay healthy can reduce your risk of heart failure,” said Gang Hu, M.D., Ph.D., lead author of the study and director of the Chronic Disease Epidemiology Laboratory at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. “Hypothetically, about half of new heart failure cases occurring in this population could have been prevented if everyone engaged in at least three healthy lifestyle behaviors.”

Previous research has shown an association between healthy lifestyle behaviors and lower risk of heart failure in men. The new study is the first to find a similar connection in women.

Researchers followed 18,346 men and 19,729 women from Finland who were 25 to 74 years old. During a median follow-up of 14.1 years, 638 men and 445 women developed heart failure. Participants were classified by BMI: normal weight (less than 25 kg/m2); overweight (25-29.9 kg/m2); and obese (greater than 30 kg/m2).

After adjusting for heart failure risk factors, such as high blood pressure, diabetes and a past heart attack, researchers found:

  • Male smokers had an 86 percent higher risk for heart failure compared to never-smokers. Women smokers’ risk increased to 109 percent.
    Being overweight increased heart failure risk by 15 percent in men and 21 percent in women compared to normal-weight people. The risk increased to 75 percent for obese men and 106 percent for obese women.
  • Moderate physical activity reduced the risk of heart failure by 21 percent in men and 13 percent in women compared to a light physical activity level. High levels of physical activity lowered the risk even further: 33 percent in men and 36 percent in women.
  • Eating vegetables three to six times per week decreased heart failure risk by 26 percent in men and 27 percent in women compared to those who ate vegetables less than once per week.
  • Furthermore, the more healthy lifestyle behaviors a person engaged in, the greater the decline in risk.

Engaging in all four healthy lifestyle behaviors decreased the risk for heart failure by 70 percent in men and 81 percent in women, compared to 32 percent in men and 47 percent in women who engaged in only one healthy behavior.

Many people remain unaware of the link between unhealthy lifestyle behaviors and heart failure risk, researchers said. Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through the heart to meet the body’s needs for blood and oxygen. Basically, the heart can’t keep up with its workload.

“Healthcare workers should discuss healthy lifestyle habits with their patients and stress that they can do more,” Hu said.