Lifestyle Changes in Young Adulthood and Middle Age and Risk of Cardiovascular Disease and All‐Cause Mortality: The Doetinchem Cohort Study. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Hulsegge, Gerben; Looman, Moniek; Smit, Henriëtte A.; Daviglus, Martha L.; van der Schouw, Yvonne T.; Verschuren, W.M. Monique
• Is Part Of: Journal of the American Heart Association. Volume 5:Issue 1(2016:Jan.)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2016-01
• Subjects: all‐cause death -- cardiovascular disease -- lifestyle; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.115.002432
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: The associations between overall lifestyle profile and cardiovascular disease (CVD) and death have been mainly investigated in cross‐sectional studies. The full benefits of a healthy lifestyle may therefore be underestimated, and the magnitude of benefits associated with changes in lifestyle remains unclear. We quantified the association of changes in lifestyle profiles over 5 years with risk of CVD and all‐cause mortality. Methods and Results: Lifestyle factors (ie, diet, physical activity, smoking, alcohol consumption) and body mass index were assessed and dichotomized as healthy/unhealthy among 5263 adults ages 26 to 66 in 1993–1997 and 5 years later (1998–2002). Multivariable‐adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were estimated to quantify associations of change in lifestyle with fatal/nonfatal CVD and all‐cause mortality that occurred 8 to 15 years after 1998–2002. Independent of baseline lifestyles, each decrement in number of healthy lifestyle factors was, on average, associated with 35% higher risk of CVD (HR, 1.35; 95% CI, 1.12–1.63) and 37% higher risk of all‐cause mortality (HR, 1.37; 95% CI, 1.10–1.70); no association was noted with increase in the number of healthy lifestyle factors ( P >0.5). Individuals who maintained 4 to 5 healthy lifestyle factors had 2.5 times lower risk of CVD (HR, 0.43; 95% CI, 0.25–0.63) and all‐cause mortality (HR, 0.40; 95% CI, 0.22–0.73) than those who maintained only 0 to 1 healthy lifestyle factor. Conclusions: Our findings suggest that the benefits of healthy lifestyles may be easier lost than gained over a 5‐year period. This underscores the need for efforts to promote maintenance of healthy lifestyles throughout the life course.