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Healthy lifestyle factors and incident heart disease and mortality in candidates for primary prevention with statin therapy.

TitleHealthy lifestyle factors and incident heart disease and mortality in candidates for primary prevention with statin therapy.
Publication TypeJournal Article
Year of Publication2016
AuthorsBooth, JN, Colantonio, LD, Howard, G, Safford, MM, Banach, M, Reynolds, K, Cushman, M, Muntner, P
JournalInt J Cardiol
Volume207
Pagination196-202
Date Published2016 Mar 15
ISSN1874-1754
KeywordsAged, Cohort Studies, Diet, Mediterranean, Energy Intake, Exercise, Female, Follow-Up Studies, Healthy Lifestyle, Heart Diseases, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Incidence, Male, Middle Aged, Mortality, Population Surveillance, Primary Prevention, Smoking, Waist Circumference
Abstract

BACKGROUND: There are limited data on the use of healthy lifestyles among adults who are candidates for primary prevention of atherosclerotic cardiovascular disease (ASCVD) with statin therapy due to a 10-year predicted risk ≥7.5%. We determined the prevalence of healthy lifestyle factors and their association with incident ASCVD and all-cause mortality in the Reason for Geographic and Racial Differences in Stroke study participants (n=5709).METHODS: Lifestyle factors (non-obese waist circumference, physical activity ≥5 times-per-week, non-smoking, low saturated-fat-intake, highest Mediterranean diet score quartile) were assessed during an in-home examination and interviewer-administered questionnaires. Adjudicated incident ASCVD (nonfatal/fatal stroke, nonfatal myocardial infarction or coronary heart disease death) and all-cause mortality were identified through active participant follow-up.RESULTS: Overall, 5.1%, 28.9%, 36.9%, 21.7% and 7.5% had 0, 1, 2, 3, and ≥4 of the 5 healthy lifestyle factors studied. There were 377 incident ASCVD events (203 CHD events and 174 strokes) and 471 deaths during 5.8 and 6.0 median years of follow-up, respectively. ASCVD incidence rates (95% CI) per 1000-person-years associated with 0, 1, 2, 3 and ≥4 healthy lifestyles were 13.4 (7.3-19.5), 12.8 (10.4-15.2), 11.0 (9.0-12.9), 11.0 (8.3-13.7), and 8.7 (4.9-12.4), respectively. Mortality rates associated with 0, 1, 2, 3 and ≥4 healthy lifestyles were 20.6 (13.3-27.8), 15.9 (13.3-18.5), 13.1 (10.9-15.2), 12.6 (9.9-15.2) and 9.2 (5.3-13.2) per 1000-person-years, respectively. The use of more healthy lifestyles was associated with lower risks for ASCVD and mortality after multivariable adjustment.CONCLUSION: Healthy lifestyles are underutilized among high-risk US adults and may substantially reduce their ASCVD risk.

DOI10.1016/j.ijcard.2016.01.001
Alternate JournalInt. J. Cardiol.
PubMed ID26803243
Grant ListK24 HL111154 / HL / NHLBI NIH HHS / United States
R01 HL080477 / HL / NHLBI NIH HHS / United States
U01 NS041588 / NS / NINDS NIH HHS / United States