The positive impact of the Life's Essential 8 in the prevention of incident heart failure

Heart failure (HF) prevalence is increasing rapidly, particularly in middle- and low-income countries, contributing to considerable treatment costs and weakening their health systems.1 Individually, cardiovascular risk factors are associated with a higher risk of developing HF. For example, the NHANES I study reported that smoking is an independent risk factor for incident HF, apart from coronary artery disease (population attributable fraction = 17%).2 A recent meta-analysis showed that hypertension is associated with a 71% increase in the risk of HF and that a 20 mmHg increase in systolic blood pressure is associated with a 28% increase in HF risk.3 Similarly, a pooled analysis of 61 prospective studies on blood pressure and mortality from HF reported a hazard ratio (HR) of 0.53 [95% confidence interval (CI): 0.48–0.59] for a 20 mmHg lower systolic blood pressure.4 However, few studies have examined the combination and the effect of the trajectory, the burden of lifestyles, and the control of risk factors in large observational studies.