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).

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