scholarly journals Healthy Lifestyle for Prevention of Premature Death Among Users and Nonusers of Common Preventive Medications: A Prospective Study in Two US Cohorts

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 85-85
Author(s):  
Kai Wang ◽  
Yanping Li ◽  
Gang Liu ◽  
Eric Rimm ◽  
Andrew Chan ◽  
...  
Keyword(s):  
Healthy Lifestyle ◽  
Premature Death ◽  
Healthy Eating Index ◽  
Lipid Lowering ◽  
Health Study ◽  
Cancer Society ◽  
Premature Deaths ◽  
All Cause Mortality ◽  
Population Attributable Risks

Abstract Objectives Adherence to healthy lifestyle and pharmacological therapies represent two major approaches to chronic disease prevention. It remains unknown whether individuals who regularly use preventive medications still benefit from adherence to healthy lifestyle as those not using the medications. We aimed to examine the associations of healthy lifestyle with all-cause and cause-specific mortality among regular users and nonusers of major preventive medications. Methods We prospectively assessed lifestyles and regular use of aspirin, antihypertensives, and lipid-lowering medications through biennial questionnaires among 79,043 women in the Nurses’ Health Study (1988–2014) and 39,544 men in the Health Professionals Follow-up Study (1986–2014). A healthy lifestyle score (ranging 0–5) was defined based on body mass index of ≥18.5 and < 27.5 kg/m2, never smoking, moderate-to-vigorous intensity activity for ≥30 minutes/day, alternate healthy eating index in the upper 40%, and light-to-moderate alcohol intake. We calculated multivariable hazard ratios (HRs) and population-attributable risks (PARs) of death from any cause, cardiovascular disease (CVD), cancer, and other causes in relation to healthy lifestyle according to medication use. Results During a median of 26 years of follow-up, we documented 35,195 deaths. A similar association of healthy lifestyle score with lower all-cause mortality was observed among medication users (HR, 0.82 per one-unit increment; 95% CI, 0.81–0.82) and nonusers (HR, 0.81 per one-unit increment; 95% CI, 0.79–0.83) (P-interaction = 0.54). The fraction of premature deaths that may potentially be prevented by adherence to all the 5 healthy lifestyle factors among medication users and nonusers was 38% (95% CI, 32–42%) and 40% (95% CI, 29–50%) for all-cause mortality, 37% (95% CI, 27–46%) and 45% (95% CI, 18–66%) for CVD mortality, 38% (95% CI, 28–46%) and 33% (95% CI, 14–49%) for cancer mortality, 33% (95% CI, 25–41%) and 38% (95% CI, 20–54%) for other mortality, respectively. Conclusions Adherence to healthy lifestyle confers substantial benefit for prevention of premature death among both regular users and nonusers of preventive medications. Adherence to healthy lifestyle remains important even among individuals regularly using preventive medications. Funding Sources American Cancer Society and NIH.

scholarly journals Healthy Lifestyle for Prevention of Premature Death Among Users and Nonusers of Common Preventive Medications: A Prospective Study in 2 US Cohorts

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Kai Wang ◽  
Yanping Li ◽  
Gang Liu ◽  
Eric Rimm ◽  
Andrew T. Chan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Healthy Lifestyle ◽  
Premature Death ◽  
Lipid Lowering ◽  
Health Study ◽  
Premature Deaths ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Population Attributable Risks ◽  
A Prospective Study

Background It remains unknown whether individuals who regularly use preventive medications receive the same benefit from healthy lifestyle as those who do not use medications. We aimed to examine the associations of healthy lifestyle with mortality according to use of major preventive medications, including aspirin, antihypertensives, and lipid‐lowering medications. Methods and Results Among 79 043 women in the Nurses' Health Study (1988–2014) and 39 544 men in the Health Professionals Follow‐up Study (1986–2014), we defined a healthy lifestyle score based on body mass index, smoking, physical activity, diet, and alcohol intake. We estimated multivariable hazard ratios (HRs) and population‐attributable risks of death from any cause, cardiovascular disease, cancer, and other causes in relation to healthy lifestyle according to medication use. We documented 35 195 deaths. A similar association of healthy lifestyle score with lower all‐cause mortality was observed among medication users (HR, 0.82 per unit increment; 95% CI, 0.81–0.82) and nonusers (HR, 0.81; 95% CI, 0.79–0.83) ( P interaction=0.54). The fraction of premature deaths that might be prevented by adherence to the 5 healthy lifestyle factors among medication users and nonusers was 38% (95% CI, 32%–42%) and 40% (95% CI, 29%–50%) for all‐cause mortality, 37% (95% CI, 27%–46%) and 45% (95% CI, 18%–66%) for cardiovascular disease mortality, and 38% (95% CI, 28%–46%) and 33% (95% CI, 14%–49%) for cancer mortality, respectively. Conclusions Adherence to a healthy lifestyle confers substantial benefit for prevention of premature death among both regular users and nonusers of preventive medications. Adherence to a healthy lifestyle remains important even among individuals regularly using preventive medications.

Abstract P367: Primordial Prevention of Coronary Heart Disease through Healthy Lifestyle in a Large Prospective Cohort of Young Women

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Andrea K Chomistek ◽  
Stephanie E Chiuve ◽  
A. H Eliassen ◽  
Kenneth J Mukamal ◽  
Eric B Rimm
Keyword(s):  
Healthy Lifestyle ◽  
Population Attributable Risk ◽  
Lifestyle Factors ◽  
Healthy Eating Index ◽  
Poor Adherence ◽  
Health Study ◽  
Cvd Risk ◽  
Primordial Prevention ◽  
Younger Women

Background: Although overall mortality rates from CHD in the U.S. have continued to decline in recent decades, the CHD mortality rate among women 35 to 54 years old has been increasing on average by 1.5% per year since 1997. This unfavorable trend may be explained, in part, by adverse lifestyle habits among younger adults. The purpose of this analysis was to estimate the burden of CHD among younger women that can be attributed to lack of adherence to a healthy lifestyle. Methods and Results: We conducted a prospective analysis among 93,161 women, 27-44 years of age at baseline, enrolled in the Nurses’ Health Study II cohort and followed from 1991 to 2009. Lifestyle factors were assessed repeatedly during follow-up by questionnaire. Healthy lifestyle was defined as not currently smoking, having a BMI of 18.5 [[Unable to Display Character: –]] 24.9 kg/m 2 , engaging in at least 2.5 hours/week of moderate to vigorous-intensity physical activity, having a diet in the top 40% of Alternative Healthy Eating Index-2010, and consuming 5 [[Unable to Display Character: –]] 30g/day of alcohol. To estimate the proportion of CHD that could be attributed to poor adherence to a healthy lifestyle, we calculated the population attributable risk percent. During follow-up, we documented 441 new cases of non-fatal MI and fatal CHD. After adjustment for other CVD risk factors, non-smoking, healthy BMI, exercise, and healthy diet were independently and significantly associated with lower CHD risk. Compared to women with 0 healthy lifestyle factors, the hazard ratio (HR) for CHD was 0.07 (95% CI, 0.03, 0.17) for women with all 5 healthy lifestyle factors (4% of the study population). Approximately 67% (95% CI 28%, 87%) of CHD cases in this population were attributable to poor adherence to a healthy lifestyle. Among non-smokers, 59% (95% CI 13%, 84%) of CHD cases were attributable to poor adherence to the other four healthy lifestyle factors. Conclusions: Primordial prevention through maintenance or adoption of a healthy lifestyle may lower incidence of CHD and potentially reverse the unfavorable trend in CHD mortality in younger women.

scholarly journals Association Between Combined Lifestyle Factors and Healthy Ageing in Chinese Adults: The Singapore Chinese Health Study

2021 ◽  
Author(s):  
Yan-Feng Zhou ◽  
Xing-Yue Song ◽  
Xiong-Fei Pan ◽  
Lei Feng ◽  
Nan Luo ◽  
...  
Keyword(s):  
Healthy Lifestyle ◽  
Population Attributable Risk ◽  
Lifestyle Factors ◽  
Healthy Eating Index ◽  
Healthy Ageing ◽  
Health Study ◽  
Moderate Activity ◽  
Chinese Adults ◽  
Singapore Chinese

Abstract Background The aim of the study was to examine the relations of individual lifestyle factors and its composite score with healthy ageing among Chinese adults. Method We included 14 159 participants aged 45–74 years at baseline from the Singapore Chinese Health Study, a population-based prospective cohort. A protective lifestyle score (0–5 scale) was calculated at baseline (1993–1998) and updated at the second follow-up visit (2006–2010) on the basis of optimal body mass index (18.5–22.9 kg/m2), healthy diet (upper 40% of the Alternative Healthy Eating Index score), being physically active (≥2 h/wk of moderate activity or ≥0.5 h/wk of strenuous activity), nonsmoking (never smoking), and low-to-moderate alcohol drinking (>0 to ≤14 drinks/wk for men and >0 to ≤7 drinks/wk for women). Healthy ageing was assessed at the third follow-up visit (2014–2016) and was defined as absence of specific chronic diseases, absence of cognitive impairment and limitations in instrumental activities of daily living, good mental and overall self-perceived health, good physical functioning, and no function-limiting pain. Results About 20.0% (2834) of the participants met the criteria of healthy ageing after a median follow-up of 20 years. Each 1-point increase in the protective lifestyle score computed at baseline and second follow-up visits was associated with higher likelihood of healthy ageing by 25% (95% CI: 20%–30%) and 24% (18%–29%), respectively. The population-attributable risk percent of adherence to 4–5 protective lifestyle factors was 34.3% (95% CI: 25.3%–42.3%) at baseline and 31.3% (23.0%–38.7%) at second follow-up visits for healthy ageing. In addition, positive increase in lifestyle scores from baseline to second follow-up visits was also significantly associated with a higher likelihood of healthy ageing with an odds ratio of 1.18 (95% CI: 1.12%–1.24%) for each increment in protective lifestyle score. Conclusions Our findings confirmed that adopting healthy lifestyle factors, even after midlife, was associated with healthy ageing at old age.

scholarly journals A U-Shaped Association between LDL-C/HDL-C Ratio and all-Cause Mortality in Elderly Hypertensive Patients: A Prospective Cohort Study

2020 ◽  
Author(s):  
Yu Yu ◽  
Minghui Li ◽  
Xiao Huang ◽  
Wei Zhou ◽  
Tao Wang ◽  
...  
Keyword(s):  
Reference Group ◽  
Survival Curve ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Hypertensive Patients ◽  
All Cause Mortality ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients

Abstract Background: Low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking LDL-C/HDL-C ratio to mortality have been inconsistent and limited by short follow-up. Therefore, the aim of the present study was to determine whether LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients.Methods: We selected 6,941 hypertensive patients aged 65 years or older and untreated with lipid-lowering drugs from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between LDL-C/HDL-C ratio and all-cause mortality by using multivariate cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve to address.Results: During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between LDL-C/HDL-C ratio and all-cause mortality. The LDL-C/HDL-C ratio was divided into five groups according to quintiles. Compared to the reference group (Q3: 1.67-2.10), both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios were associated with higher all-cause mortality (<1.67: HR 1.81, 95% CI: 1.08-3.03; ≥2.10: HR 2.00, 95% CI: 1.18-3.39). Compare with lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratio of 1.67-2.10 had a significant higher survival probability (log-rank P = 0.038).Conclusion: Our results suggested that there was a U-shaped association between LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.

Abstract 5008: Lifestyle Practices in Adults 65 Years and Older and 7-Year Follow-up Mortality: The Chicago Heart Association Detection Project in Industry Study (CHA)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Thanh Huyen T Vu ◽  
Daniel B Garside ◽  
Martha L Daviglus
Keyword(s):  
Healthy Lifestyle ◽  
Heavy Drinking ◽  
Heart Association ◽  
Older Age ◽  
Unhealthy Lifestyle ◽  
Industry Study ◽  
Hazard Ratios ◽  
Lifestyle Practices ◽  
All Cause Mortality

Background and Objective : Prospective data on combined effects of lifestyle practices (smoking, heavy drinking, and physical inactivity) in older age on mortality are limited. We examine the combined impact of lifestyle behaviors in adults 65 years and older on CVD, non-CVD, cancer, and all-cause mortality after 7 years of follow-up. Methods : In 1996, a health survey was mailed to all surviving participants, ages 65–102, from the Chicago Heart Association Detection Project in Industry Study. The response rate was 60% and the sample included 4,200 male and 3,288 female respondents. Unhealthy lifestyle (un-HL) practices were classified into three groups as having two or more , one , or none of the following three un-HL factors (current smoking or stopped smoking only within the past 10 years; heavy drinking ->15 g/day for women or >30 g/day for men; and infrequent exercise). Vital status was ascertained through 2003 via the National Death Index. Results : With adjustment for age, race, education, marital status, living arrangement, and BMI, the hazards of CVD, non-CVD, cancer, and all-cause mortality were highest among men and women who had two or more un-HL factors and lowest among those who had healthy lifestyle. For example, in men, compared to those with none un-HL factors, the hazard ratios (95%CIs) of all-cause death for those with two or more and one un-HL factors were 2.10 (1.73–2.46) and 1.56 (1.36–1.77), respectively. Associations were attenuated somewhat but remained strongly significant with further adjustment for comorbidities (see table ). Conclusion : Having no unhealthy lifestyle factors in older age is associated with a lower risk for CVD, non-CVD, cancer, and all-cause death. These results should encourage healthy lifestyle practices in elderly people to decrease mortality and promote longevity. Adjusted* Hazard Ratios (95% CIs) for CVD, Non-CVD, Cancer, and All-Cause Death by Number of Unhealthy Lifestyle Factors in 1996 and Gender

Abstract 18995: Statins in Familial Hypercholesterolemia - Effects on Coronary Artery Disease and All-cause Mortality

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Joost Besseling ◽  
Gerard K Hovingh ◽  
John J Kastelein ◽  
Barbara A Hutten
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Familial Hypercholesterolemia ◽  
Lipid Lowering ◽  
Premature Coronary Artery Disease ◽  
Lipid Lowering Therapy ◽  
Time Varying ◽  
All Cause Mortality ◽  
Artery Disease

Introduction: Heterozygous familial hypercholesterolemia (heFH) is characterized by high levels of low-density lipoprotein cholesterol (LDL-C) and increased risk for premature coronary artery disease (CAD) and death. Reduction of CAD and mortality by statins has not been properly quantified in heFH. The aim of the current study is to determine the effect of statins on CAD and mortality in heFH. Methods: All adult heFH patients identified by the Dutch FH screening program between 1994 and 2014 and registered in the PHARMO Database Network were eligible. Of these patients we obtained hospital, pharmacy (in- and outpatient), and mortality records in the period between 1995 and 2015. The effect of statins (time-varying) on CAD and all-cause mortality was determined using a Cox proportional hazard model, while correcting for the use of other lipid-lowering therapy, thrombocyte aggregation inhibitors, antihypertensive and antidiabetic medication (all time-varying). Furthermore, we used inverse probability for treatment weighting (IPTW) to account for differences between statin-treated and untreated patients regarding history of CAD before follow-up, age at start of follow-up and age of screening, as well as body mass index, LDL-C and triglycerides. Results: Of the 25,479 identified heFH patients, 11,021 gave informed consent to obtain their medical records, of whom 2,447 could be retrieved. We excluded 766 patients younger than 18. The remaining 1,681 heFH patients comprised our study population and these had very similar characteristics as compared to the 23,798 excluded FH patients, e.g. mean (SD) LDL-C levels were 214 (74) vs. 203 (77) mg/dL. Among 1,151 statin users, there were 133 CAD events and 15 deaths during 10,115 statin treated person-years, compared to 17 CAD events and 9 deaths during 4,965 person-years in 530 never statin users (combined rate: 14.6 vs. 5.2, respectively, p<0.001). After applying IPTW to account for indication bias and correcting for use of other medications, the hazard ratio of statin use for CAD and all-cause mortality was 0.61 (0.40 - 0.93). Conclusions: In heFH patients, statins lower the risk for CAD and mortality by 39%.

scholarly journals Association of social relationships with incident cardiovascular events and all-cause mortality

Heart ◽  
2020 ◽  
Vol 106 (17) ◽  
pp. 1317-1323
Author(s):  
Janine Gronewold ◽  
Rene Kropp ◽  
Nils Lehmann ◽  
Börge Schmidt ◽  
Simone Weyers ◽  
...  
Keyword(s):  
Social Integration ◽  
Social Relationships ◽  
Cardiovascular Event ◽  
Financial Support ◽  
Cardiovascular Events ◽  
Cox Proportional Hazards ◽  
Lipid Lowering ◽  
Targeted Interventions ◽  
All Cause Mortality

ObjectiveTo examine how different aspects of social relationships are associated with incident cardiovascular events and all-cause mortality.MethodsIn 4139 participants from the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean (SD) age 59.1 (7.7) years, 46.7% men), the association of self-reported instrumental, emotional and financial support and social integration at baseline with incident fatal and non-fatal cardiovascular events and all-cause mortality during 13.4-year follow-up was assessed in five different multivariable Cox proportional hazards regression models: minimally adjusted model (adjusting for age, sex, social integration or social support, respectively); biological model (minimally adjusted+systolic blood pressure, low-density and high-density lipoprotein cholesterol, glycated haemoglobin, body mass index, antihypertensive medication, lipid-lowering medication and antidiabetic medication); health behaviour model (minimally adjusted+alcohol consumption, smoking and physical activity); socioeconomic model (minimally adjusted+income, education and employment); and depression model (minimally adjusted+depression, antidepressants and anxiolytics).Results339 cardiovascular events and 530 deaths occurred during follow-up. Lack of financial support was associated with an increased cardiovascular event risk (minimally adjusted HR=1.30(95% CI 1.01 to 1.67)). Lack of social integration (social isolation) was associated with increased mortality (minimally adjusted HR=1.47 (95% CI 1.09 to 1.97)). Effect estimates did not decrease to a relevant extent in any regression model.ConclusionsPerceiving a lack of financial support is associated with a higher cardiovascular event incidence, and being socially isolated is associated with increased all-cause mortality. Future studies should investigate how persons with deficient social relationships could benefit from targeted interventions.

scholarly journals Dietary Pattern and Risk of Multiple Myeloma in Two Large Prospective US Cohort Studies

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dong Hoon Lee ◽  
Teresa T Fung ◽  
Fred K Tabung ◽  
Graham A Colditz ◽  
Irene M Ghobrial ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Dietary Pattern ◽  
Association Studies ◽  
Positive Association ◽  
Healthy Eating Index ◽  
Health Study ◽  
Men Health ◽  
Cox Proportional Hazard Models ◽  
Inflammatory Pattern

AbstractBackgroundThe limited data on specific dietary components and risk of multiple myeloma (MM) show no consistent association. Studies have not examined the association of dietary pattern with MM risk.MethodsIn prospective cohorts of 69 751 women (Nurses’ Health Study, 1984–2014) and 47 232 men (Health Professionals Follow-up Study, 1986–2014), we examined the association between dietary pattern and risk of MM using Cox proportional hazard models. Diet was assessed repeatedly every 4 years with food frequency questionnaires and was used to calculate dietary patterns including the Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent and Western patterns, the empirical dietary inflammatory pattern (EDIP), and empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH).ResultsDuring 2 792 257 person-years of follow-up, we identified 478 incident MM cases (215 women, 263 men). In men, high EDIP was statistically significantly associated with a 16% increase in MM risk (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 1.02 to 1.32 per 1-SD increase). Moreover, EDIR and EDIH had a suggestive positive association (EDIR: HR = 1.09, 95% CI = 0.96 to 1.24; and EDIH: HR = 1.11, 95% CI = 0.97 to 1.28 per 1-SD increase). We observed no other associations with MM risk in men and no associations for any dietary pattern with MM risk in women.ConclusionsWe present the first evidence for a role of diets with higher inflammatory or insulinemic potential in MM development. Further studies are warranted to explore these associations in other populations, including the apparent restriction to men.

scholarly journals Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes

2020 ◽  
Vol 9 (3) ◽  
pp. 753
Author(s):  
Shailesh Kumar Samal ◽  
Abdul Rashid Qureshi ◽  
Mizanur Rahman ◽  
Peter Stenvinkel ◽  
Johan Frostegård
Keyword(s):  
Significant Risk ◽  
Premature Death ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Multivariate Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Low Levels ◽  
Antibody Levels

Patients on haemodialysis (HD-patients) have an increased risk of premature death. Low levels of IgM antibodies against malondialdehyde (anti-MDA) are associated with increased risk of cardiovascular disease (CVD) with underlying potential mechanisms described. Here, we studied subclasses and isotypes of anti-MDA in 210 HD-patients with mortality as outcome (56% men, median age 66, Interquartile range (IQR) 51–74 years, vintage time 29 (15–58) months, mean follow up period of 41 (20–60)months). Patients were also divided into inflamed c-reactive protein (CRP >5.6 mg/mL) and non-inflamed. Antibody levels were measured by ELISA. In multivariate risk analysis, patients in low tertile of IgM anti-MDA sub-distribution hazard ratio (sHR 0.54); 95% confidence interval (CI: 0.34–0.89) inversely and significantly associated with all-cause mortality after five years, after adjusting for confounders. Low tertile of IgG (sHR 0.48, 95%CI: 0.25–0.90, p = 0.02) and IgG1 (sHR 0.50, CI: 0.24–1.04, p = 0.06) was associated low mortality among non-inflamed patients. In contrast, anti-MDA IgG2 among inflamed patients was significantly associated with increased mortality, IgG2(sHR 2.33, CI: 1.16–4.68, p = 0.01). IgM anti-MDA was a novel biomarker among HD-patients with low levels being associated with mortality, while low levels of IgG and IgG1 but not IgA anti-MDA were associated with mortality only among non-inflamed patients. IgG2 anti-MDA was a significant risk marker among inflamed patients, which could be related to infection.

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