Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults

Ruotong Yang; Jun Lv; Canqing Yu; Yu Guo; Zheng Bian; Yuting Han; Ling Yang; Yiping Chen; Huaidong Du; Jianjun Liu; Chan Qu; Junshi Chen; Zhengming Chen; Robert Clarke; Tao Huang; Liming Li; Junshi Chen; Zhengming Chen; Robert Clarke; Rory Collins; Yu Guo; Liming Li; Jun Lv; Richard Peto; Robin Walters; Daniel Avery; Ruth Boxall; Derrick Bennett; Yumei Chang; Yiping Chen; Zhengming Chen; Robert Clarke; Huaidong Du; Simon Gilbert; Alex Hacker; Mike Hill; Michael Holmes; Andri Iona; Christiana Kartsonaki; Rene Kerosi; Ling Kong; Om Kurmi; Garry Lancaster; Sarah Lewington; Kuang Lin; John McDonnell; Iona Millwood; Qunhua Nie; Jayakrishnan Radhakrishnan; Paul Ryder; Sam Sansome; Dan Schmidt; Paul Sherliker; Rajani Sohoni; Becky Stevens; Iain Turnbull; Robin Walters; Jenny Wang; Lin Wang; Neil Wright; Ling Yang; Xiaoming Yang; Zheng Bian; Yu Guo; Xiao Han; Can Hou; Jun Lv; Pei Pei; Chao Liu; Canqing Yu; Zengchang Pang; Ruqin Gao; Shanpeng Li; Shaojie Wang; Yongmei Liu; Ranran Du; Yajing Zang; Liang Cheng; Xiaocao Tian; Hua Zhang; Yaoming Zhai; Feng Ning; Xiaohui Sun; Feifei Li; Silu Lv; Junzheng Wang; Wei Hou; Mingyuan Zeng; Ge Jiang; Xue Zhou; Liqiu Yang; Hui He; Bo Yu; Yanjie Li; Qinai Xu; Quan Kang; Ziyan Guo; Dan Wang; Ximin Hu; Jinyan Chen; Yan Fu; Zhenwang Fu; Xiaohuan Wang; Min Weng; Zhendong Guo; Shukuan Wu; Yilei Li; Huimei Li; Zhifang Fu; Ming Wu; Yonglin Zhou; Jinyi Zhou; Ran Tao; Jie Yang; Jian Su; Fang Liu; Jun Zhang; Yihe Hu; Yan Lu; Liangcai Ma; Aiyu Tang; Shuo Zhang; Jianrong Jin; Jingchao Liu; Zhenzhu Tang; Naying Chen; Ying Huang; Mingqiang Li; Jinhuai Meng; Rong Pan; Qilian Jiang; Jian Lan; Yun Liu; Liuping Wei; Liyuan Zhou; Ningyu Chen; Ping Wang; Fanwen Meng; Yulu Qin; Sisi Wang; Xianping Wu; Ningmei Zhang; Xiaofang Chen; Weiwei Zhou; Guojin Luo; Jianguo Li; Xiaofang Chen; Xunfu Zhong; Jiaqiu Liu; Qiang Sun; Pengfei Ge; Xiaolan Ren; Caixia Dong; Hui Zhang; Enke Mao; Xiaoping Wang; Tao Wang; Xi Zhang; Ding Zhang; Gang Zhou; Shixian Feng; Liang Chang; Lei Fan; Yulian Gao; Tianyou He; Huarong Sun; Pan He; Chen Hu; Xukui Zhang; Huifang Wu; Pan He; Min Yu; Ruying Hu; Hao Wang; Tongxiang Cdc; Yijian Qian; Chunmei Wang; Kaixu Xie; Lingli Chen; Yidan Zhang; Dongxia Pan; Qijun Gu; Yuelong Huang; Biyun Chen; Li Yin; Huilin Liu; Zhongxi Fu; Qiaohua Xu; Xin Xu; Hao Zhang; Huajun Long; Xianzhi Li; Libo Zhang; Zhe Qiu

doi:10.1093/ije/dyab236

Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults

Ruotong Yang, Jun Lv, Canqing Yu, Yu Guo, Zheng Bian, Yuting Han, Ling Yang, Yiping Chen, Huaidong Du, Jianjun Liu, Chan Qu, Junshi Chen, Zhengming Chen, Robert Clarke, Tao Huang, Liming Li, Junshi Chen, Zhengming Chen, Robert Clarke, Rory CollinsYu Guo, Liming Li, Jun Lv, Richard Peto, Robin Walters, Daniel Avery, Ruth Boxall, Derrick Bennett, Yumei Chang, Yiping Chen, Zhengming Chen, Robert Clarke, Huaidong Du, Simon Gilbert, Alex Hacker, Mike Hill, Michael Holmes, Andri Iona, Christiana Kartsonaki, Rene Kerosi, Ling Kong, Om Kurmi, Garry Lancaster, Sarah Lewington, Kuang Lin, John McDonnell, Iona Millwood, Qunhua Nie, Jayakrishnan Radhakrishnan, Paul Ryder, Sam Sansome, Dan Schmidt, Paul Sherliker, Rajani Sohoni, Becky Stevens, Iain Turnbull, Robin Walters, Jenny Wang, Lin Wang, Neil Wright, Ling Yang, Xiaoming Yang, Zheng Bian, Yu Guo, Xiao Han, Can Hou, Jun Lv, Pei Pei, Chao Liu, Canqing Yu, Zengchang Pang, Ruqin Gao, Shanpeng Li, Shaojie Wang, Yongmei Liu, Ranran Du, Yajing Zang, Liang Cheng, Xiaocao Tian, Hua Zhang, Yaoming Zhai, Feng Ning, Xiaohui Sun, Feifei Li, Silu Lv, Junzheng Wang, Wei Hou, Mingyuan Zeng, Ge Jiang, Xue Zhou, Liqiu Yang, Hui He, Bo Yu, Yanjie Li, Qinai Xu, Quan Kang, Ziyan Guo, Dan Wang, Ximin Hu, Jinyan Chen, Yan Fu, Zhenwang Fu, Xiaohuan Wang, Min Weng, Zhendong Guo, Shukuan Wu, Yilei Li, Huimei Li, Zhifang Fu, Ming Wu, Yonglin Zhou, Jinyi Zhou, Ran Tao, Jie Yang, Jian Su, Fang Liu, Jun Zhang, Yihe Hu, Yan Lu, Liangcai Ma, Aiyu Tang, Shuo Zhang, Jianrong Jin, Jingchao Liu, Zhenzhu Tang, Naying Chen, Ying Huang, Mingqiang Li, Jinhuai Meng, Rong Pan, Qilian Jiang, Jian Lan, Yun Liu, Liuping Wei, Liyuan Zhou, Ningyu Chen, Ping Wang, Fanwen Meng, Yulu Qin, Sisi Wang, Xianping Wu, Ningmei Zhang, Xiaofang Chen, Weiwei Zhou, Guojin Luo, Jianguo Li, Xiaofang Chen, Xunfu Zhong, Jiaqiu Liu, Qiang Sun, Pengfei Ge, Xiaolan Ren, Caixia Dong, Hui Zhang, Enke Mao, Xiaoping Wang, Tao Wang, Xi Zhang, Ding Zhang, Gang Zhou, Shixian Feng, Liang Chang, Lei Fan, Yulian Gao, Tianyou He, Huarong Sun, Pan He, Chen Hu, Xukui Zhang, Huifang Wu, Pan He, Min Yu, Ruying Hu, Hao Wang, Tongxiang Cdc, Yijian Qian, Chunmei Wang, Kaixu Xie, Lingli Chen, Yidan Zhang, Dongxia Pan, Qijun Gu, Yuelong Huang, Biyun Chen, Li Yin, Huilin Liu, Zhongxi Fu, Qiaohua Xu, Xin Xu, Hao Zhang, Huajun Long, Xianzhi Li, Libo Zhang, Zhe Qiu

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

8 Citations (Scopus)

Abstract

Background: The relative importance of healthy lifestyle factors and cardiovascular health metrics for the risk of heart failure is uncertain in Chinese populations. We aimed to compare the strength of associations between healthy lifestyle factors and ideal cardiovascular health metrics in the risk of heart failure in middle-Aged Chinese adults. Methods: A healthy lifestyle score (HLS) was constructed using smoking, drinking, physical activity, diet, body mass index and waist circumference, and compared with a more comprehensive set of metrics that included cardiovascular-disease risk biomarkers (blood pressure, blood glucose and blood lipids) in addition to the HLS. This broader set of factors [called 'ideal cardiovascular health metrics' (ICVHMs)] was evaluated in 487 197 participants in the China Kadoorie Biobank. Results: A total of 4208 incident cases of heart failure were recorded during a median follow-up of 10 years. Both HLS [hazard ratio (HR), 0.88; 95% confidence interval (CI), 0.85, 0.91] and ICVHMs (0.87: 0.84, 0.89) were inversely associated with risk of heart failure (P < 0.001 for linear trend). Compared with participants with 0-1 HLS, the multivariable-Adjusted HR of those with 4-5 HLS was 0.68 (0.59, 0.77). Compared with participants with 0-2 ICVHMs, the adjusted HR (95% CIs) of those who had 7-8 ICVHMs was 0.47 (0.36, 0.60). ICVHMs were more strongly predictive of risk of heart failure (area under curve, 0.61 vs 0.58, P < 0.001) than healthy lifestyle factors alone. Conclusions: Higher levels of healthy lifestyle factors and ICVHMs were each inversely associated with heart failure, and lifestyle factors combined with cardiometabolic factors improved the prediction of heart failure compared with healthy lifestyle factors alone.

Original language	English
Pages (from-to)	567-578
Number of pages	12
Journal	International Journal of Epidemiology
Volume	51
Issue number	2
Early online date	21 Dec 2021
DOIs	https://doi.org/10.1093/ije/dyab236
Publication status	Published - 1 Apr 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2021 The Author(s) 2021; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Keywords

cardiovascular health metrics
healthy lifestyle
Heart failure

ASJC Scopus subject areas

Epidemiology

UN SDGs

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

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10.1093/ije/dyab236

Cite this

Yang, R., Lv, J., Yu, C., Guo, Y., Bian, Z., Han, Y., Yang, L., Chen, Y., Du, H., Liu, J., Qu, C., Chen, J., Chen, Z., Clarke, R., Huang, T., Li, L., Chen, J., Chen, Z., Clarke, R., ... Qiu, Z. (2022). Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults. International Journal of Epidemiology, 51(2), 567-578. https://doi.org/10.1093/ije/dyab236

Yang, R, Lv, J, Yu, C, Guo, Y, Bian, Z, Han, Y, Yang, L, Chen, Y, Du, H, Liu, J, Qu, C, Chen, J, Chen, Z, Clarke, R, Huang, T, Li, L, Chen, J, Chen, Z, Clarke, R, Collins, R, Guo, Y, Li, L, Lv, J, Peto, R, Walters, R, Avery, D, Boxall, R, Bennett, D, Chang, Y, Chen, Y, Chen, Z, Clarke, R, Du, H, Gilbert, S, Hacker, A, Hill, M, Holmes, M, Iona, A, Kartsonaki, C, Kerosi, R, Kong, L, Kurmi, O, Lancaster, G, Lewington, S, Lin, K, McDonnell, J, Millwood, I, Nie, Q, Radhakrishnan, J, Ryder, P, Sansome, S, Schmidt, D, Sherliker, P, Sohoni, R, Stevens, B, Turnbull, I, Walters, R, Wang, J, Wang, L, Wright, N, Yang, L, Yang, X, Bian, Z, Guo, Y, Han, X, Hou, C, Lv, J, Pei, P, Liu, C, Yu, C, Pang, Z, Gao, R, Li, S, Wang, S, Liu, Y, Du, R, Zang, Y, Cheng, L, Tian, X, Zhang, H, Zhai, Y, Ning, F, Sun, X, Li, F, Lv, S, Wang, J, Hou, W, Zeng, M, Jiang, G, Zhou, X, Yang, L, He, H, Yu, B, Li, Y, Xu, Q, Kang, Q, Guo, Z, Wang, D, Hu, X, Chen, J, Fu, Y, Fu, Z, Wang, X, Weng, M, Guo, Z, Wu, S, Li, Y, Li, H, Fu, Z, Wu, M, Zhou, Y, Zhou, J, Tao, R, Yang, J, Su, J, Liu, F, Zhang, J, Hu, Y, Lu, Y, Ma, L, Tang, A, Zhang, S, Jin, J, Liu, J, Tang, Z, Chen, N, Huang, Y, Li, M, Meng, J, Pan, R, Jiang, Q, Lan, J, Liu, Y, Wei, L, Zhou, L, Chen, N, Wang, P, Meng, F, Qin, Y, Wang, S, Wu, X, Zhang, N, Chen, X, Zhou, W, Luo, G, Li, J, Chen, X, Zhong, X, Liu, J, Sun, Q, Ge, P, Ren, X, Dong, C, Zhang, H, Mao, E, Wang, X, Wang, T, Zhang, X, Zhang, D, Zhou, G, Feng, S, Chang, L, Fan, L, Gao, Y, He, T, Sun, H, He, P, Hu, C, Zhang, X, Wu, H, He, P, Yu, M, Hu, R, Wang, H, Cdc, T, Qian, Y, Wang, C, Xie, K, Chen, L, Zhang, Y, Pan, D, Gu, Q, Huang, Y, Chen, B, Yin, L, Liu, H, Fu, Z, Xu, Q, Xu, X, Zhang, H, Long, H, Li, X, Zhang, L & Qiu, Z 2022, 'Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults', International Journal of Epidemiology, vol. 51, no. 2, pp. 567-578. https://doi.org/10.1093/ije/dyab236

@article{579465eb854d4df9a49d440a39f7b254,

title = "Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults",

abstract = "Background: The relative importance of healthy lifestyle factors and cardiovascular health metrics for the risk of heart failure is uncertain in Chinese populations. We aimed to compare the strength of associations between healthy lifestyle factors and ideal cardiovascular health metrics in the risk of heart failure in middle-Aged Chinese adults. Methods: A healthy lifestyle score (HLS) was constructed using smoking, drinking, physical activity, diet, body mass index and waist circumference, and compared with a more comprehensive set of metrics that included cardiovascular-disease risk biomarkers (blood pressure, blood glucose and blood lipids) in addition to the HLS. This broader set of factors [called 'ideal cardiovascular health metrics' (ICVHMs)] was evaluated in 487 197 participants in the China Kadoorie Biobank. Results: A total of 4208 incident cases of heart failure were recorded during a median follow-up of 10 years. Both HLS [hazard ratio (HR), 0.88; 95% confidence interval (CI), 0.85, 0.91] and ICVHMs (0.87: 0.84, 0.89) were inversely associated with risk of heart failure (P < 0.001 for linear trend). Compared with participants with 0-1 HLS, the multivariable-Adjusted HR of those with 4-5 HLS was 0.68 (0.59, 0.77). Compared with participants with 0-2 ICVHMs, the adjusted HR (95% CIs) of those who had 7-8 ICVHMs was 0.47 (0.36, 0.60). ICVHMs were more strongly predictive of risk of heart failure (area under curve, 0.61 vs 0.58, P < 0.001) than healthy lifestyle factors alone. Conclusions: Higher levels of healthy lifestyle factors and ICVHMs were each inversely associated with heart failure, and lifestyle factors combined with cardiometabolic factors improved the prediction of heart failure compared with healthy lifestyle factors alone. ",

keywords = "cardiovascular health metrics, healthy lifestyle, Heart failure",

author = "Ruotong Yang and Jun Lv and Canqing Yu and Yu Guo and Zheng Bian and Yuting Han and Ling Yang and Yiping Chen and Huaidong Du and Jianjun Liu and Chan Qu and Junshi Chen and Zhengming Chen and Robert Clarke and Tao Huang and Liming Li and Junshi Chen and Zhengming Chen and Robert Clarke and Rory Collins and Yu Guo and Liming Li and Jun Lv and Richard Peto and Robin Walters and Daniel Avery and Ruth Boxall and Derrick Bennett and Yumei Chang and Yiping Chen and Zhengming Chen and Robert Clarke and Huaidong Du and Simon Gilbert and Alex Hacker and Mike Hill and Michael Holmes and Andri Iona and Christiana Kartsonaki and Rene Kerosi and Ling Kong and Om Kurmi and Garry Lancaster and Sarah Lewington and Kuang Lin and John McDonnell and Iona Millwood and Qunhua Nie and Jayakrishnan Radhakrishnan and Paul Ryder and Sam Sansome and Dan Schmidt and Paul Sherliker and Rajani Sohoni and Becky Stevens and Iain Turnbull and Robin Walters and Jenny Wang and Lin Wang and Neil Wright and Ling Yang and Xiaoming Yang and Zheng Bian and Yu Guo and Xiao Han and Can Hou and Jun Lv and Pei Pei and Chao Liu and Canqing Yu and Zengchang Pang and Ruqin Gao and Shanpeng Li and Shaojie Wang and Yongmei Liu and Ranran Du and Yajing Zang and Liang Cheng and Xiaocao Tian and Hua Zhang and Yaoming Zhai and Feng Ning and Xiaohui Sun and Feifei Li and Silu Lv and Junzheng Wang and Wei Hou and Mingyuan Zeng and Ge Jiang and Xue Zhou and Liqiu Yang and Hui He and Bo Yu and Yanjie Li and Qinai Xu and Quan Kang and Ziyan Guo and Dan Wang and Ximin Hu and Jinyan Chen and Yan Fu and Zhenwang Fu and Xiaohuan Wang and Min Weng and Zhendong Guo and Shukuan Wu and Yilei Li and Huimei Li and Zhifang Fu and Ming Wu and Yonglin Zhou and Jinyi Zhou and Ran Tao and Jie Yang and Jian Su and Fang Liu and Jun Zhang and Yihe Hu and Yan Lu and Liangcai Ma and Aiyu Tang and Shuo Zhang and Jianrong Jin and Jingchao Liu and Zhenzhu Tang and Naying Chen and Ying Huang and Mingqiang Li and Jinhuai Meng and Rong Pan and Qilian Jiang and Jian Lan and Yun Liu and Liuping Wei and Liyuan Zhou and Ningyu Chen and Ping Wang and Fanwen Meng and Yulu Qin and Sisi Wang and Xianping Wu and Ningmei Zhang and Xiaofang Chen and Weiwei Zhou and Guojin Luo and Jianguo Li and Xiaofang Chen and Xunfu Zhong and Jiaqiu Liu and Qiang Sun and Pengfei Ge and Xiaolan Ren and Caixia Dong and Hui Zhang and Enke Mao and Xiaoping Wang and Tao Wang and Xi Zhang and Ding Zhang and Gang Zhou and Shixian Feng and Liang Chang and Lei Fan and Yulian Gao and Tianyou He and Huarong Sun and Pan He and Chen Hu and Xukui Zhang and Huifang Wu and Pan He and Min Yu and Ruying Hu and Hao Wang and Tongxiang Cdc and Yijian Qian and Chunmei Wang and Kaixu Xie and Lingli Chen and Yidan Zhang and Dongxia Pan and Qijun Gu and Yuelong Huang and Biyun Chen and Li Yin and Huilin Liu and Zhongxi Fu and Qiaohua Xu and Xin Xu and Hao Zhang and Huajun Long and Xianzhi Li and Libo Zhang and Zhe Qiu",

year = "2022",

month = apr,

day = "1",

doi = "10.1093/ije/dyab236",

language = "English",

volume = "51",

pages = "567--578",

journal = "International Journal of Epidemiology",

issn = "0300-5771",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults

AU - Yang, Ruotong

AU - Lv, Jun

AU - Yu, Canqing

AU - Guo, Yu

AU - Bian, Zheng

AU - Han, Yuting

AU - Yang, Ling

AU - Chen, Yiping

AU - Du, Huaidong

AU - Liu, Jianjun

AU - Qu, Chan

AU - Chen, Junshi

AU - Chen, Zhengming

AU - Clarke, Robert

AU - Huang, Tao

AU - Li, Liming

AU - Chen, Junshi

AU - Chen, Zhengming

AU - Clarke, Robert

AU - Collins, Rory

AU - Guo, Yu

AU - Li, Liming

AU - Lv, Jun

AU - Peto, Richard

AU - Walters, Robin

AU - Avery, Daniel

AU - Boxall, Ruth

AU - Bennett, Derrick

AU - Chang, Yumei

AU - Chen, Yiping

AU - Chen, Zhengming

AU - Clarke, Robert

AU - Du, Huaidong

AU - Gilbert, Simon

AU - Hacker, Alex

AU - Hill, Mike

AU - Holmes, Michael

AU - Iona, Andri

AU - Kartsonaki, Christiana

AU - Kerosi, Rene

AU - Kong, Ling

AU - Kurmi, Om

AU - Lancaster, Garry

AU - Lewington, Sarah

AU - Lin, Kuang

AU - McDonnell, John

AU - Millwood, Iona

AU - Nie, Qunhua

AU - Radhakrishnan, Jayakrishnan

AU - Ryder, Paul

AU - Sansome, Sam

AU - Schmidt, Dan

AU - Sherliker, Paul

AU - Sohoni, Rajani

AU - Stevens, Becky

AU - Turnbull, Iain

AU - Walters, Robin

AU - Wang, Jenny

AU - Wang, Lin

AU - Wright, Neil

AU - Yang, Ling

AU - Yang, Xiaoming

AU - Bian, Zheng

AU - Guo, Yu

AU - Han, Xiao

AU - Hou, Can

AU - Lv, Jun

AU - Pei, Pei

AU - Liu, Chao

AU - Yu, Canqing

AU - Pang, Zengchang

AU - Gao, Ruqin

AU - Li, Shanpeng

AU - Wang, Shaojie

AU - Liu, Yongmei

AU - Du, Ranran

AU - Zang, Yajing

AU - Cheng, Liang

AU - Tian, Xiaocao

AU - Zhang, Hua

AU - Zhai, Yaoming

AU - Ning, Feng

AU - Sun, Xiaohui

AU - Li, Feifei

AU - Lv, Silu

AU - Wang, Junzheng

AU - Hou, Wei

AU - Zeng, Mingyuan

AU - Jiang, Ge

AU - Zhou, Xue

AU - Yang, Liqiu

AU - He, Hui

AU - Yu, Bo

AU - Li, Yanjie

AU - Xu, Qinai

AU - Kang, Quan

AU - Guo, Ziyan

AU - Wang, Dan

AU - Hu, Ximin

AU - Chen, Jinyan

AU - Fu, Yan

AU - Fu, Zhenwang

AU - Wang, Xiaohuan

AU - Weng, Min

AU - Guo, Zhendong

AU - Wu, Shukuan

AU - Li, Yilei

AU - Li, Huimei

AU - Fu, Zhifang

AU - Wu, Ming

AU - Zhou, Yonglin

AU - Zhou, Jinyi

AU - Tao, Ran

AU - Yang, Jie

AU - Su, Jian

AU - Liu, Fang

AU - Zhang, Jun

AU - Hu, Yihe

AU - Lu, Yan

AU - Ma, Liangcai

AU - Tang, Aiyu

AU - Zhang, Shuo

AU - Jin, Jianrong

AU - Liu, Jingchao

AU - Tang, Zhenzhu

AU - Chen, Naying

AU - Huang, Ying

AU - Li, Mingqiang

AU - Meng, Jinhuai

AU - Pan, Rong

AU - Jiang, Qilian

AU - Lan, Jian

AU - Liu, Yun

AU - Wei, Liuping

AU - Zhou, Liyuan

AU - Chen, Ningyu

AU - Wang, Ping

AU - Meng, Fanwen

AU - Qin, Yulu

AU - Wang, Sisi

AU - Wu, Xianping

AU - Zhang, Ningmei

AU - Chen, Xiaofang

AU - Zhou, Weiwei

AU - Luo, Guojin

AU - Li, Jianguo

AU - Chen, Xiaofang

AU - Zhong, Xunfu

AU - Liu, Jiaqiu

AU - Sun, Qiang

AU - Ge, Pengfei

AU - Ren, Xiaolan

AU - Dong, Caixia

AU - Zhang, Hui

AU - Mao, Enke

AU - Wang, Xiaoping

AU - Wang, Tao

AU - Zhang, Xi

AU - Zhang, Ding

AU - Zhou, Gang

AU - Feng, Shixian

AU - Chang, Liang

AU - Fan, Lei

AU - Gao, Yulian

AU - He, Tianyou

AU - Sun, Huarong

AU - He, Pan

AU - Hu, Chen

AU - Zhang, Xukui

AU - Wu, Huifang

AU - He, Pan

AU - Yu, Min

AU - Hu, Ruying

AU - Wang, Hao

AU - Cdc, Tongxiang

AU - Qian, Yijian

AU - Wang, Chunmei

AU - Xie, Kaixu

AU - Chen, Lingli

AU - Zhang, Yidan

AU - Pan, Dongxia

AU - Gu, Qijun

AU - Huang, Yuelong

AU - Chen, Biyun

AU - Yin, Li

AU - Liu, Huilin

AU - Fu, Zhongxi

AU - Xu, Qiaohua

AU - Xu, Xin

AU - Zhang, Hao

AU - Long, Huajun

AU - Li, Xianzhi

AU - Zhang, Libo

AU - Qiu, Zhe

PY - 2022/4/1

Y1 - 2022/4/1

N2 - Background: The relative importance of healthy lifestyle factors and cardiovascular health metrics for the risk of heart failure is uncertain in Chinese populations. We aimed to compare the strength of associations between healthy lifestyle factors and ideal cardiovascular health metrics in the risk of heart failure in middle-Aged Chinese adults. Methods: A healthy lifestyle score (HLS) was constructed using smoking, drinking, physical activity, diet, body mass index and waist circumference, and compared with a more comprehensive set of metrics that included cardiovascular-disease risk biomarkers (blood pressure, blood glucose and blood lipids) in addition to the HLS. This broader set of factors [called 'ideal cardiovascular health metrics' (ICVHMs)] was evaluated in 487 197 participants in the China Kadoorie Biobank. Results: A total of 4208 incident cases of heart failure were recorded during a median follow-up of 10 years. Both HLS [hazard ratio (HR), 0.88; 95% confidence interval (CI), 0.85, 0.91] and ICVHMs (0.87: 0.84, 0.89) were inversely associated with risk of heart failure (P < 0.001 for linear trend). Compared with participants with 0-1 HLS, the multivariable-Adjusted HR of those with 4-5 HLS was 0.68 (0.59, 0.77). Compared with participants with 0-2 ICVHMs, the adjusted HR (95% CIs) of those who had 7-8 ICVHMs was 0.47 (0.36, 0.60). ICVHMs were more strongly predictive of risk of heart failure (area under curve, 0.61 vs 0.58, P < 0.001) than healthy lifestyle factors alone. Conclusions: Higher levels of healthy lifestyle factors and ICVHMs were each inversely associated with heart failure, and lifestyle factors combined with cardiometabolic factors improved the prediction of heart failure compared with healthy lifestyle factors alone.

AB - Background: The relative importance of healthy lifestyle factors and cardiovascular health metrics for the risk of heart failure is uncertain in Chinese populations. We aimed to compare the strength of associations between healthy lifestyle factors and ideal cardiovascular health metrics in the risk of heart failure in middle-Aged Chinese adults. Methods: A healthy lifestyle score (HLS) was constructed using smoking, drinking, physical activity, diet, body mass index and waist circumference, and compared with a more comprehensive set of metrics that included cardiovascular-disease risk biomarkers (blood pressure, blood glucose and blood lipids) in addition to the HLS. This broader set of factors [called 'ideal cardiovascular health metrics' (ICVHMs)] was evaluated in 487 197 participants in the China Kadoorie Biobank. Results: A total of 4208 incident cases of heart failure were recorded during a median follow-up of 10 years. Both HLS [hazard ratio (HR), 0.88; 95% confidence interval (CI), 0.85, 0.91] and ICVHMs (0.87: 0.84, 0.89) were inversely associated with risk of heart failure (P < 0.001 for linear trend). Compared with participants with 0-1 HLS, the multivariable-Adjusted HR of those with 4-5 HLS was 0.68 (0.59, 0.77). Compared with participants with 0-2 ICVHMs, the adjusted HR (95% CIs) of those who had 7-8 ICVHMs was 0.47 (0.36, 0.60). ICVHMs were more strongly predictive of risk of heart failure (area under curve, 0.61 vs 0.58, P < 0.001) than healthy lifestyle factors alone. Conclusions: Higher levels of healthy lifestyle factors and ICVHMs were each inversely associated with heart failure, and lifestyle factors combined with cardiometabolic factors improved the prediction of heart failure compared with healthy lifestyle factors alone.

KW - cardiovascular health metrics

KW - healthy lifestyle

KW - Heart failure

UR - http://www.scopus.com/inward/record.url?scp=85132928462&partnerID=8YFLogxK

U2 - 10.1093/ije/dyab236

DO - 10.1093/ije/dyab236

M3 - Article

AN - SCOPUS:85132928462

SN - 0300-5771

VL - 51

SP - 567

EP - 578

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

IS - 2

ER -

Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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