Lifestyle improvement and the reduced risk of cardiovascular disease: the China-PAR project.
10.26599/1671-5411.2023.11.005
- Author:
Ying-Ying JIANG
1
;
Fang-Chao LIU
2
;
Chong SHEN
1
;
Jian-Xin LI
2
;
Ke-Yong HUANG
2
;
Xue-Li YANG
3
,
4
;
Ji-Chun CHEN
2
;
Xiao-Qing LIU
5
;
Jie CAO
2
;
Shu-Feng CHEN
2
;
Ling YU
6
;
Ying-Xin ZHAO
7
;
Xian-Ping WU
8
;
Lian-Cheng ZHAO
2
;
Ying LI
2
;
Dong-Sheng HU
9
;
Jian-Feng HUANG
2
;
Xiang-Feng LU
2
;
Dong-Feng GU
1
Author Information
1. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
2. Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
3. Tianjin Key Laboratory of Environment, Nutrition and Public Health
4. Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
5. Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China.
6. Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China.
7. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China.
8. Sichuan Center for Disease Control and Prevention, Chengdu, China.
9. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
- Publication Type:Journal Article
- From:
Journal of Geriatric Cardiology
2023;20(11):779-787
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:The benefits of healthy lifestyles are well recognized. However, the extent to which improving unhealthy lifestyles reduces cardiovascular disease (CVD) risk needs to be discussed. We evaluated the impact of lifestyle improvement on CVD incidence using data from the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China).
METHODS:A total of 12,588 participants free of CVD were followed up for three visits after the baseline examination. Changes in four lifestyle factors (LFs) (smoking, diet, physical activity, and alcohol consumption) were assessed through questionnaires from the baseline to the first follow-up visit. Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). The risk advancement periods (RAPs: the age difference between exposed and unexposed participants reaching the same incident CVD risk) and population-attributable risk percentage (PAR%) were also calculated.
RESULTS:A total of 909 incident CVD cases occurred over a median follow-up of 11.14 years. Compared with maintaining 0-1 healthy LFs, maintaining 3-4 healthy LFs was associated with a 40% risk reduction of incident CVD (HR = 0.60, 95% CI: 0.45-0.79) and delayed CVD risk by 6.31 years (RAP: -6.31 [-9.92, -2.70] years). The PAR% of maintaining 3-4 unhealthy LFs was 22.0% compared to maintaining 0-1 unhealthy LFs. Besides, compared with maintaining two healthy LFs, improving healthy LFs from 2 to 3-4 was associated with a 23% lower risk of CVD (HR = 0.77, 95% CI: 0.60-0.98).
CONCLUSIONS:Long-term sustenance of healthy lifestyles or improving unhealthy lifestyles can reduce and delay CVD risk.
