Chronic diseases are the leading cause of death and disability in most of the world and cardiovascular diseases (CVD) lead the pack. While there is evidence of some clinical progress in reducing CVD morbidity and mortality, lifestyle and culture play a vital role. 

Methodological issues of some of the studies reviewed in this editorial, notwithstanding, there's "a common message: healthy lifestyle is associated with reduced risk of both hypertension and heart failure—2 highly prevalent illnesses that are associated with high morbidity and mortality and that have an enormous effect on the individual, society, and health care costs.  Importantly, several factors are protective against both conditions."

Roger VL."Lifestyle and Cardiovascular Health; Individual and Societal Choices." JAMA. 2009;302(4):437-439.

• The following "modifiable lifestyle and dietary factors" had a protective effect against hypertension: 1) body mass index (BMI) less than 25, 2) vigorous daily exercise, 3) a Dietary Approaches to Stop Hypertension (DASH)–style diet, 4) modest alcohol intake, 5) the use of non-narcotic analgesic less than one time a week, and 6) taking 400 µg or more of supplemental folic acid a day. "Whereas all factors were associated with reduced risk of developing hypertension, body mass index exhibited the strongest association, with a large population-attributable risk equating 40%. If all women were at low risk for the 6 factors, a staggering 78% of new-onset hypertension might potentially be prevented or at least delayed."

Forman JP, Stampfer MJ, Curhan GC. "Diet and lifestyle risk factors associated with incident hypertension in women."  JAMA. 2009;302(4):401-411.

• Another study evaluated the "protective association between lifestyle and the development of heart failure." Similarly to the study above, there were six modifiable lifestyle factors: 1) having and maintaining normal weight, 2) not smoking, 3) exercising regularly, 4) moderating alcohol intake, 5) eating breakfast cereal, and 6) fruits and vegetables. The more compliance with these, the less chance of developing heart failure. "This relationship was strong, as indicated by a lifetime risk of heart failure of 21% in men with none of the factors vs 10% in those with 4 or more desirable lifestyle factors. Importantly, the relationship was robust and persisted when lifestyle factors over time were examined; when factors were restricted to adiposity, smoking,and exercise; and when analyses were restricted to persons with antecedent myocardial infarction, type 2 diabetes mellitus, or hypertension."

Djoussé L, Driver JA, Gaziano JM. "Relation between modifiable lifestyle factors and lifetime risk of heart failure." JAMA. 2009;302(4):394-400.