Researchers analyzed over 1 million people across 139 studies to find the best ways to prevent heart disease. They discovered that blood pressure and cholesterol medications work very well, reducing heart problems by 19-34%. Intensive lifestyle programs that change multiple habits at once also help significantly. Government policies like reducing salt in food and controlling tobacco could prevent thousands of deaths yearly. Most prevention methods are worth the cost, making them good investments for both individuals and society.

The Quick Take

  • What they studied: How well different heart disease prevention methods work, including medications, lifestyle changes, and government policies
  • Who participated: Over 1 million people from 139 different studies, plus analysis of 95 previous research reviews
  • Key finding: Blood pressure medications reduced heart problems by 24%, cholesterol drugs by 19%, and intensive lifestyle programs by 25%
  • What it means for you: If you’re at risk for heart disease, medications and comprehensive lifestyle changes are your best bets for prevention

The Research Details

This was a comprehensive analysis that combined five different types of research. The scientists looked at 95 previous studies, used computer algorithms to screen research papers, and directly compared results from 139 clinical trials involving over 1 million people. They also used computer models to predict how government policies might affect entire populations and analyzed whether prevention methods are worth their cost.

This approach is powerful because it combines evidence from many different studies and methods. Instead of relying on just one study, the researchers could see patterns across hundreds of thousands of people and different types of interventions.

The researchers used rigorous methods including comprehensive searches, duplicate screening by multiple reviewers, and standard quality assessments. However, they note limitations including differences between studies and lack of direct head-to-head comparisons for some treatments.

What the Results Show

Blood pressure medications were among the most effective, reducing heart disease events and deaths by 24%. Intensive blood pressure control was even better, cutting risks by 34%. Cholesterol-lowering statin drugs reduced heart disease deaths by 11-29% and major heart events by 10-41%. Diabetes medications called SGLT2 inhibitors reduced major heart problems by 8% and death by 6%. Multifactorial lifestyle interventions that addressed multiple risk factors at once reduced heart problems by 25%.

Aspirin helped prevent heart problems in 8 out of 17 studies, with risk reductions of 3-15%. Vitamin D supplements showed modest benefits with 6-7% risk reductions. Dietary changes alone had limited evidence but showed some promise with 9% risk reduction in one analysis. Most single lifestyle interventions like exercise alone or individual supplements showed little clear benefit.

These findings confirm and strengthen previous research showing that medications for blood pressure and cholesterol are highly effective for heart disease prevention. The research also provides new evidence that comprehensive lifestyle programs work better than single interventions.

The studies varied significantly in their methods and populations, making direct comparisons challenging. Many lifestyle interventions lacked high-quality evidence. The researchers couldn’t account for all possible confounding factors, and some analyses relied on computer models rather than direct observations.

The Bottom Line

For high-risk individuals, blood pressure and cholesterol medications are strongly recommended based on solid evidence. Intensive lifestyle programs addressing multiple factors simultaneously are also beneficial. Government policies targeting salt reduction and tobacco control are highly recommended for population-wide prevention.

People at risk for heart disease should focus on proven medications and comprehensive lifestyle changes. Single supplements or isolated lifestyle changes have limited evidence. Those with diabetes may benefit from newer SGLT2 inhibitor medications.

Medication benefits typically appear within 1-2 years of starting treatment. Lifestyle program benefits may take 6 months to 2 years to become apparent. Population-level policy changes show benefits over 5-10 years.

Want to Apply This Research?

  • Track blood pressure readings, cholesterol levels, and multiple lifestyle factors including diet quality, exercise minutes, and medication adherence
  • Focus on comprehensive lifestyle programs rather than single changes - track diet, exercise, stress management, and sleep together as a package
  • Monitor cardiovascular risk factors monthly, lifestyle adherence weekly, and work with healthcare providers to optimize both medication and lifestyle interventions

This information is for educational purposes only and should not replace professional medical advice. Consult your healthcare provider before starting or stopping any medications or making significant lifestyle changes, especially if you have existing health conditions or take other medications.