🫀Heart disease

#1Body weight[1, 2]≈+180%

In 57 studies and 900,000 adults, each 5 BMI units above 25 went with 40% more vascular deaths, after adjusting for age, sex and smoking.

How would you describe your weight?

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#2Smoking[3]+107%

Across 25 cohorts and half a million adults over 60, current smokers died of cardiovascular disease at about twice the rate of never smokers, and former smokers at about 1.4 times, with the excess fading the longer they had quit.

Do you smoke?

Same number, 2 answers: The CHANCES consortium compared current smokers with never smokers and did not split by cigarettes a day.

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#3High blood pressure[4, 5]≈+100%

In one million adults, each 20 mmHg of usual systolic pressure went with a twofold difference in deaths from ischaemic heart disease at ages 40 to 69, all the way down to 115 mmHg.

What’s your blood pressure like?

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#4Diabetes[6]2×

Across 102 studies and 700,000 people free of vascular disease, diabetes doubled coronary heart disease after adjusting for age, sex, smoking, blood pressure and weight.

What’s your blood sugar like?

Same number, 2 answers: The collaboration compared diabetes with no diabetes; it did not split by how well it was controlled.

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#5Early heart disease in the family[7]2×

In 2,300 Framingham offspring followed for 30 years, having a parent with premature cardiovascular disease (before 55 in a father, 65 in a mother) doubled a man’s odds of an event and raised a woman’s by 70%, after adjusting for the usual risk factors.

Has a parent, brother, or sister had heart disease before about age 60?

Same number, 2 answers: The Framingham analysis compared at least one parent with premature cardiovascular disease against none; it did not count how many relatives.

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#6Depression[8]+81%

In 21 cohorts of people free of heart disease, depression went with 81% more future coronary heart disease.

How often do you feel down or depressed?

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#7Sleep apnea[9, 10]+79%

In 12 prospective cohorts and 26,000 people, severe obstructive sleep apnea carried 79% more cardiovascular disease than no apnea, with each 10 extra pauses an hour adding 17%.

Do you snore loudly or wake up gasping?

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#8Autoimmune or inflammatory disease[11]+56%

Among 22 million people in UK primary care records, the 446,000 with an autoimmune disease developed cardiovascular disease 56% more often than matched controls, across every kind of cardiovascular disease and rising with the number of conditions.

Do you have a chronic inflammatory or autoimmune condition (rheumatoid arthritis, IBD, psoriasis, lupus)?

Same number, 2 answers: The CPRD records compared people with an autoimmune disease against matched controls and did not grade how well the disease was controlled.

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#9High cholesterol[12, 13]≈+52%

In 900,000 adults, 1 mmol/L lower total cholesterol went with a third fewer deaths from ischaemic heart disease at ages 50 to 69 (about half at 40 to 49, a sixth at 70 to 89).

What’s your cholesterol like?

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#10Sleep length[14]+48%

Across 15 prospective studies and 470,000 people, short sleepers developed or died of coronary heart disease 48% more often than people sleeping seven to eight hours, and long sleepers 38% more often.

How much sleep do you usually get?

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#11Binge drinking[15, 16]+45%

Across 14 studies, people who drank heavily on occasion had 45% more ischaemic heart disease than regular moderate drinkers.

How often do you have 4+ alcoholic drinks in one sitting?

Same number, 2 answers: The review pooled irregular heavy drinking occasions of any frequency against regular moderate drinking and did not split monthly from weekly.

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#12Processed meat[17]+42%

Across 20 studies and 1.2 million people, each daily 50 g serving of processed meat (bacon, deli meat, sausage) went with 42% more coronary heart disease, while unprocessed red meat went with none.

How often do you eat processed meat (bacon, deli, sausage)?

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#13Physical inactivity[18]−35%

Across 33 cohorts and 880,000 people, the most active groups had 35% fewer cardiovascular deaths than the least active.

How many days a week do you get 30+ minutes of exercise?

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#14Social isolation[19]+29%

Across 23 studies and 181,000 people, loneliness or social isolation went with 29% more first coronary heart disease events (and 32% more strokes).

How connected are you to friends and family?

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#15Secondhand smoke[20]+25%

Across 18 studies, non-smokers who lived or worked with smoke had 25% more coronary heart disease than non-smokers who did not, with a dose gradient from 23% at one to 19 cigarettes a day of exposure to 31% at 20 or more.

How often are you around other people’s smoke?

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#16Eating pattern[21]−25%

Across the prospective cohorts in Dinu’s review [21], vegetarians developed or died of ischaemic heart disease 25% less often than omnivores.

Which eating pattern best describes you?

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#17Few legumes[22]≈−23%

Across 5 studies and half a million people, each 4 weekly 100 g servings of beans, lentils or chickpeas went with 14% less total ischaemic heart disease.

How often do you eat legumes (beans, lentils, chickpeas)?

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#18Sugary drinks[23]+19%

In 118,000 US nurses and health professionals followed for three decades, cardiovascular deaths rose step by step with sugary drinks, from 10% more at a few a week to 31% more at two or more a day, after adjusting for diet, weight and lifestyle.

How often do you drink sugary drinks?

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#19Little fibre[24, 25]≈−17%

Across 22 cohorts, each extra 7 g of fibre a day went with 9% less coronary heart disease; the Lancet carbohydrate-quality review put the highest fibre eaters 15 to 30% below the lowest for cardiovascular death, with most of the gain by 25 to 29 g a day.

How much fiber do you eat (whole grains, beans, fruit, vegetables)?

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#20No strength training[26]−17%

Across 16 studies, people who did any muscle-strengthening activity had 17% less cardiovascular disease than people who did none, independent of aerobic exercise.

How often do you do strength training?

Same number, 2 answers: The review pooled any muscle-strengthening activity against none, and the dose-response curve peaked at 30–60 minutes a week with no further gain, so more sessions do not earn a lower number.

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#21Long working hours[27]+17%

In the WHO and ILO systematic review of 37 studies and 770,000 workers, working 55 hours or more a week went with 17% more deaths from ischaemic heart disease than 35 to 40 hours, and 13% more new cases.

How many hours a week do you work?

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#22Few fruit and vegetables[28]≈−15%

Across 16 cohorts and 830,000 people, each extra daily serving of fruit or vegetables went with 4% fewer cardiovascular deaths, with no further gain past about five servings.

How many servings of vegetables and fruit do you eat a day?

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#23No coffee or tea[29]≈−15%

In a dose-response meta-analysis of 36 cohorts and 1.28 million people, coffee drinkers carried less cardiovascular disease than non-drinkers across a nonlinear curve that bottomed out around three and a half cups a day.

What does your daily caffeine mostly look like?

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#24Resting heart rate[30]≈−7%

Across 46 studies and 1.2 million people, each 10 beats a minute of resting heart rate went with 8% more cardiovascular deaths; 60 to 80 beats carried 8% more than the lowest band and over 80 carried 33% more.

What’s your resting heart rate?

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#25Sitting time[31]

Across 14 studies, the people who sat the most died of cardiovascular disease 18% more often than those who sat the least, after adjusting for how much they exercised.

How many hours a day are you sitting?

Same number, 2 answers: The review pooled each study’s most sedentary band against its least, and the cut for “most” was around eight hours; it did not measure a band above eleven.

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#26Chronic stress[32]

Across six prospective studies and 118,000 people, high perceived stress went with 27% more new coronary heart disease than low stress.

How stressed are you day to day?

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