Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population

China Kadoorie Biobank (CKB) collaborative group; Jun Lv; Canqing Yu; Yu Guo; Zheng Bian; Ling Yang; Yiping Chen; Xuefeng Tang; Weiyuan Zhang; Yijian Qian; Yuelong Huang; Xiaoping Wang; Junshi Chen; Zhengming Chen; Lu Qi; Liming Li

doi:10.1016/j.jacc.2016.11.076

Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population

China Kadoorie Biobank (CKB) collaborative group
, Jun Lv
, Canqing Yu
, Yu Guo
, Zheng Bian
, Ling Yang
, Yiping Chen
, Xuefeng Tang
, Weiyuan Zhang
, Yijian Qian
, Yuelong Huang
, Xiaoping Wang
, Junshi Chen
, Zhengming Chen
, Lu Qi
, Liming Li

Peking University
Chinese Academy of Medical Sciences
University of Oxford
Sichuan Provincial Center for Disease Control and Prevention
Liuzhou Center for Disease Control
Tongxiang Centre for Disease Control and Prevention
NCDs Prevention and Control Department, Hunan CDC
Maiji CDC
China National Center for Food Safety Risk Assessment
Tulane University
Harvard University

Research output: Contribution to journal › Article › peer-review

255 Citations (Scopus)

41 Downloads (Pure)

Abstract

BACKGROUND: Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.

OBJECTIVES: This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.

METHODS: This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women.

RESULTS: During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle.

CONCLUSIONS: Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.

Original language	English
Pages (from-to)	1116-1125
Number of pages	10
Journal	Journal of the American College of Cardiology
Volume	69
Issue number	9
Early online date	27 Feb 2017
DOIs	https://doi.org/10.1016/j.jacc.2016.11.076
Publication status	Published - 7 Mar 2017

Bibliographical note

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Adult
Aged
Asian Continental Ancestry Group/psychology
Cardiovascular Diseases/ethnology
China
Cohort Studies
Female
Health Behavior
Healthy Lifestyle
Humans
Male
Middle Aged
Patient Compliance

Access to Document

10.1016/j.jacc.2016.11.076Licence: CC BY-NC-ND

PublishedFinal published version, 522 KBLicence: CC BY-NC-ND

Cite this

China Kadoorie Biobank (CKB) collaborative group, Lv, J., Yu, C., Guo, Y., Bian, Z., Yang, L., Chen, Y., Tang, X., Zhang, W., Qian, Y., Huang, Y., Wang, X., Chen, J., Chen, Z., Qi, L., & Li, L. (2017). Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population. Journal of the American College of Cardiology, 69(9), 1116-1125. https://doi.org/10.1016/j.jacc.2016.11.076

China Kadoorie Biobank (CKB) collaborative group, Lv, J, Yu, C, Guo, Y, Bian, Z, Yang, L, Chen, Y, Tang, X, Zhang, W, Qian, Y, Huang, Y, Wang, X, Chen, J, Chen, Z, Qi, L & Li, L 2017, 'Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population', Journal of the American College of Cardiology, vol. 69, no. 9, pp. 1116-1125. https://doi.org/10.1016/j.jacc.2016.11.076

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title = "Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population",

abstract = "BACKGROUND: Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.OBJECTIVES: This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.METHODS: This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women.RESULTS: During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95\% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95\% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9\% (95\% confidence interval: 46.5\% to 81.9\%) of the MCE and 39.1\% (95\% confidence interval: 26.4\% to 50.4\%) of the IS cases were attributable to poor adherence to healthy lifestyle.CONCLUSIONS: Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.",

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AU - China Kadoorie Biobank (CKB) collaborative group

AU - Lv, Jun

AU - Yu, Canqing

AU - Guo, Yu

AU - Bian, Zheng

AU - Yang, Ling

AU - Chen, Yiping

AU - Tang, Xuefeng

AU - Zhang, Weiyuan

AU - Qian, Yijian

AU - Huang, Yuelong

AU - Wang, Xiaoping

AU - Chen, Junshi

AU - Chen, Zhengming

AU - Qi, Lu

AU - Li, Liming

AU - Kurmi, Om

PY - 2017/3/7

Y1 - 2017/3/7

N2 - BACKGROUND: Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.OBJECTIVES: This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.METHODS: This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women.RESULTS: During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle.CONCLUSIONS: Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.

AB - BACKGROUND: Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.OBJECTIVES: This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.METHODS: This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women.RESULTS: During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle.CONCLUSIONS: Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.

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KW - Cohort Studies

KW - Female

KW - Health Behavior

KW - Healthy Lifestyle

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Compliance

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