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

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• 作者：John N. Booth III<sup>asup> ; Lisandro D. Colantonio<sup>asup> ; George Howard<sup>asup> ; Monika M. Safford<sup>asup> ; Maciej Banach<sup>bsup> ; Kristi Reynolds<sup>csup> ; Mary Cushman<sup>dsup> ; Paul Muntner<sup>asup><sup> ; sup><sup>pmuntner@uab.edu" class="auth_mail" title="E-mail the corresponding authorsup>
• 关键词：Healthy lifestyle ; Statins ; Atherosclerotic cardiovascular disease ; Cholesterol treatment guidelines ; Atherosclerotic cardiovascular disease risk ; Mortality
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 March 2016
• 年：2016
• 卷：207
• 期：Complete
• 页码：196-202
• 全文大小：406 K

文摘

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).

sSec_2">Methods

sp0075">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.

sSec_3">Results

sp0080">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&ndash;19.5), 12.8 (10.4&ndash;15.2), 11.0 (9.0&ndash;12.9), 11.0 (8.3&ndash;13.7), and 8.7 (4.9&ndash;12.4), respectively. Mortality rates associated with 0, 1, 2, 3 and ≥ 4 healthy lifestyles were 20.6 (13.3&ndash;27.8), 15.9 (13.3&ndash;18.5), 13.1 (10.9&ndash;15.2), 12.6 (9.9&ndash;15.2) and 9.2 (5.3&ndash;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.

sSec_4">Conclusion

sp0085">Healthy lifestyles are underutilized among high-risk US adults and may substantially reduce their ASCVD risk.