Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease Among Young Women

Abstract Background Overall mortality rates from coronary heart disease (CHD) in the United States have declined in recent decades, but the rate has plateaued among younger women. The potential for further reductions in mortality rates among young women through changes in lifestyle is unknown. Objec...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2015-01, Vol.65 (1), p.43-51
Main Authors: Chomistek, Andrea K., ScD, Chiuve, Stephanie E., ScD, Eliassen, A. Heather, ScD, Mukamal, Kenneth J., MD, MPH, Willett, Walter C., MD, DrPH, Rimm, Eric B., ScD
Format: Article
Language:English
Subjects:
Adult
Cardiology
Cardiovascular
Cardiovascular disease
coronary disease
Coronary Disease - epidemiology
Coronary Disease - prevention & control
diabetes
epidemiology
Female
Health Behavior
Health risk assessment
Humans
hypercholesterolemia
hypertension
Internal Medicine
Life Style
Mortality
Multivariate Analysis
Primary Prevention
Proportional Hazards Models
Prospective Studies
Risk Factors
Womens health
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Overall mortality rates from coronary heart disease (CHD) in the United States have declined in recent decades, but the rate has plateaued among younger women. The potential for further reductions in mortality rates among young women through changes in lifestyle is unknown. Objectives The aim of this study was to estimate the proportion of CHD cases and clinical cardiovascular disease (CVD) risk factors among young women that might be attributable to poor adherence to a healthy lifestyle. Methods A prospective analysis was conducted among 88,940 women ages 27 to 44 years at baseline in the Nurses’ Health Study II who were followed from 1991 to 2011. Lifestyle factors were updated repeatedly by questionnaire. A healthy lifestyle was defined as not smoking, a normal body mass index, physical activity ≥ 2.5 h/week, television viewing ≤ 7 h/week, diet in the top 40% of the Alternative Healthy Eating Index–2010, and 0.1 to 14.9 g/day of alcohol. To estimate the proportion of CHD and clinical CVD risk factors (diabetes, hypertension, and hypercholesterolemia) that could be attributed to poor adherence to a healthy lifestyle, we calculated the population-attributable risk percent. Results During 20 years of follow-up, we documented 456 incident CHD cases. In multivariable-adjusted models, nonsmoking, a healthy body mass index, exercise, and a healthy diet were independently and significantly associated with lower CHD risk. Compared with women with no healthy lifestyle factors, the hazard ratio for CHD for women with 6 lifestyle factors was 0.08 (95% confidence interval: 0.03 to 0.22). Approximately 73% (95% confidence interval: 39% to 89%) of CHD cases were attributable to poor adherence to a healthy lifestyle. Similarly, 46% (95% confidence interval: 43% to 49%) of clinical CVD risk factor cases were attributable to a poor lifestyle. Conclusions Primordial prevention through maintenance of a healthy lifestyle among young women may substantially lower the burden of CVD.
ISSN:0735-1097
1558-3597
1558-3597
DOI:10.1016/j.jacc.2014.10.024