Yingting Zuo1,2,3,4, Haibin Li5, Shuohua Chen6, Xue Tian1,2,3,4, Dapeng Mo1,2, Shouling Wu7, Anxin Wang8,9. 1. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 3. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. 4. Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. 5. Department of Cardiac Surgery, Heart Center, and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. 6. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China. 7. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China. drwusl@163.com. 8. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. wanganxin@bjtth.org. 9. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. wanganxin@bjtth.org.
Abstract
PURPOSE: We aimed to identify the joint associations of modifiable lifestyle and metabolic factors with the incidences of cardiovascular disease and all-cause mortality. METHODS: We recruited 94,831 participants (men, 79.76%; median age, 51.60 [43.47-58.87]) without a history of cardiovascular disease from the Kailuan study during 2006 and 2007 and followed them until a cardiovascular disease event, or death occurred, or until December 31, 2017. Baseline metabolic health status was assessed using Adult Treatment Panel III criteria, and details of the lifestyles of the participants were recorded using a self-reported questionnaire. We used Cox proportional hazards models to evaluate the joint associations. RESULTS: During a median follow-up of 11.03 years, we recorded 6590 cardiovascular disease events and 9218 all-cause mortality. Participants with the most metabolic risk components and the least healthy lifestyle had higher risk of cardiovascular disease (hazard ratio 2.06 [95% confidence interval (CI) 1.77-2.39]) and mortality (HR 1.53 [95% CI 1.31-1.78]), than participants with fewer metabolic risk components and the healthiest lifestyle. Compared with those in participants with the healthiest lifestyle, the HRs for cardiovascular disease in participants with the least healthy lifestyle were 1.26 (95% CI 1.17-1.37), 1.16 (95% CI 1.03-1.31), and 1.07 (95% CI 0.90-1.27) for those with low, medium, and high metabolic risk, respectively. CONCLUSION: Healthy lifestyle is associated with a lower risk of cardiovascular disease and there is no significant interaction between metabolic risk and a healthy lifestyle. Therefore, a healthy lifestyle should be promoted, even for people with high metabolic risk.
PURPOSE: We aimed to identify the joint associations of modifiable lifestyle and metabolic factors with the incidences of cardiovascular disease and all-cause mortality. METHODS: We recruited 94,831 participants (men, 79.76%; median age, 51.60 [43.47-58.87]) without a history of cardiovascular disease from the Kailuan study during 2006 and 2007 and followed them until a cardiovascular disease event, or death occurred, or until December 31, 2017. Baseline metabolic health status was assessed using Adult Treatment Panel III criteria, and details of the lifestyles of the participants were recorded using a self-reported questionnaire. We used Cox proportional hazards models to evaluate the joint associations. RESULTS: During a median follow-up of 11.03 years, we recorded 6590 cardiovascular disease events and 9218 all-cause mortality. Participants with the most metabolic risk components and the least healthy lifestyle had higher risk of cardiovascular disease (hazard ratio 2.06 [95% confidence interval (CI) 1.77-2.39]) and mortality (HR 1.53 [95% CI 1.31-1.78]), than participants with fewer metabolic risk components and the healthiest lifestyle. Compared with those in participants with the healthiest lifestyle, the HRs for cardiovascular disease in participants with the least healthy lifestyle were 1.26 (95% CI 1.17-1.37), 1.16 (95% CI 1.03-1.31), and 1.07 (95% CI 0.90-1.27) for those with low, medium, and high metabolic risk, respectively. CONCLUSION: Healthy lifestyle is associated with a lower risk of cardiovascular disease and there is no significant interaction between metabolic risk and a healthy lifestyle. Therefore, a healthy lifestyle should be promoted, even for people with high metabolic risk.
Authors: Larry B Goldstein; Robert Adams; Mark J Alberts; Lawrence J Appel; Lawrence M Brass; Cheryl D Bushnell; Antonio Culebras; Thomas J DeGraba; Philip B Gorelick; John R Guyton; Robert G Hart; George Howard; Margaret Kelly-Hayes; J V Ian Nixon; Ralph L Sacco Journal: Circulation Date: 2006-06-20 Impact factor: 29.690
Authors: Soha M Abd El Dayem; Ahmed A Battah; Abo El Magd El Bohy; Amal El Shehaby; Esmat Abd El Ghaffar Journal: J Pediatr Endocrinol Metab Date: 2015-03 Impact factor: 1.634