The Study
Factors of health in the protection against death and cardiovascular disease among adults with subclinical atherosclerosis
This study found that people with early signs of heart disease who don’t smoke, stay active, and feel less stressed tended to live longer and have fewer heart problems — but we can’t say those things caused it. Maybe people who are already healthier just do those things, or other things we didn’t measure helped them.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
Even if your arteries have a lot of plaque, doing healthy things like not smoking, moving more, and managing stress can still help you live longer and avoid heart attacks.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 559 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — these are large, meaningful reductions in risk for people already at high risk due to plaque buildup.
- 2Not smoking: 40% less death risk, 42% less heart disease.
- 3Low stress: 23-29% less death, 29% less heart disease.
- 4More exercise: 36% less death.
- 5Normal blood sugar: 31% less death.
- 6High good cholesterol: 38% less heart disease.
- 7Each extra healthy habit cuts risk by 11%.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
American Heart Journal
Year
2017
Authors
Mahmoud Al Rifai, P. Greenland, M. Blaha, E. Michos, K. Nasir, M. Miedema, J. Yeboah, V. Sandfort, A. Frazier-Wood, S. Shea, J. Lima, M. Szklo, W. Post, R. Blumenthal, J. McEvoy
Related Content
Claims (8)
Getting enough sleep, exercising regularly, and eating healthy foods can protect your heart just as well as taking medicine.
Getting enough sleep, exercising regularly, and eating healthy foods can protect your heart just as well as taking medicine.
If you're an adult with early signs of heart disease but no symptoms yet, being very active can help you live longer and avoid heart problems — studies suggest it might delay death by over 30%.
If you have plaque in your heart arteries but your blood sugar is normal, you’re less likely to die early and live longer — but it doesn’t seem to stop heart attacks. So keeping your blood sugar in check might help you live longer, even if it doesn’t prevent heart problems.
For people with already high calcium buildup in their heart arteries, having higher levels of 'good' cholesterol seems to lower their chance of having a heart attack or stroke—but it doesn’t seem to help them live longer.
If you’re an adult with early signs of heart artery damage but don’t smoke, you’re much less likely to die or have a heart attack or stroke compared to smokers—even if your heart is already showing damage. Quitting smoking might still help you live longer and healthier, even at this stage.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.