Abstract 025: Association of Dietary Patterns and Lifetime Risk of Heart Failure: The Cardiovascular Disease Lifetime Risk Pooling Project

Introduction: Modifiable healthy lifestyle factors have been associated with lower risk of developing heart failure (HF). However, the role of dietary patterns in relation to lifetime risk (LR) of HF and years lived free of HF is not established. We hypothesized that better diet quality scores would be associated with lower risk of HF and more years lived free of HF. Methods: We included individual-level pooled data from 7 US population-based cohorts stratified by index age groups (middle-aged [40-59 years] and older [60-79 years]), sex, and race. We calculated the alternate Healthy Eating Index-2010 (AHEI) score for all participants and performed (1) modified Kaplan-Meier analysis to estimate LR of HF, (2) competing Cox models (adjusted for age, smoking, education, body mass index, physical activity, hypertension, and diabetes) to estimate joint cumulative risks for HF or death, and (3) Irwin restricted mean to estimates years lived free of and with HF. Results: Of the 39,082 middle-aged participants free of HF at baseline, 15% of participants were black and 84% were women. Over 125,214 person-years of follow-up, LR for HF was highest in those with the lowest quality diet (quintile 1) compared with those in higher aHEI quintiles ( FIGURE ). Competing hazard ratios for HF among middle-aged black men and women in the lowest quintile were 2.56 (95% confidence interval [CI] 1.38, 4.76) and 2.33 (95% CI 1.34, 4.04) compared with individuals in the highest quintile, with similar findings in white adults. Participants in the lowest aHEI quintile lived significantly fewer healthy years free of HF compared with those in the highest aHEI quintile (p<0.05 for all sex-race groups). Similar patterns were observed in black and white older adults (index age 60-79 years). Discussion: A higher (better) diet quality score is independently associated with lower risk of HF and greater proportion of life lived without HF. Public health policies supporting adherence to the AHEI dietary recommendations may decrease the growing burden of HF.