Table 3.

Summary of Study Design and Key Findings

Prior key findings from relevant Cardiovascular Disease Lifetime Risk Pooling Project studies	Lifetime risk estimates for total cardiovascular are high for all individuals, but optimal risk factor profile in middle age is associated with longer time free from total cardiovascular disease (Wilkins et al. [6]) Lifetime risk estimates for heart failure are high, but they are lower for those with optimal blood pressure or lower body mass index in an adjusted model (Huffman et al. [1])
Study objectives	Quantify the association between different mid-life, heart failure-specific risk factor profiles and risk for new onset heart failure, years lived free from heart failure, and overall survival Examine whether lower risk factor burden in mid-life is associated with heart failure-related compression of morbidity
Cohorts sampled from Cardiovascular Disease Lifetime Risk Pooling Project	Framingham Heart Study Framingham Offspring Study ARIC (Atherosclerosis Risk In Communities) Study Chicago Heart Association and Detection Study
Key findings	Absence of hypertension, diabetes, and obesity, compared to the presence of all 3 risk factors, in mid-life is associated on average with substantially lower risks of new onset heart failure (hazard ratios 0.27 for men and 0.15 for women at age 45 yrs), >10 yrs longer heart-failure free survival, and up to 13 yrs longer overall survival Absence of hypertension, diabetes, and obesity, compared to the presence of all 3 risk factors, in mid-life is associated on average with lower percentage of life lived with heart failure in the context of longer overall survival