Key result
Highest healthy lifestyle scores are linked to ~52% lower CVD risk in normal-BMI postmenopausal women.
Why the study?
Although healthy lifestyle components are linked to reduced CVD risk, the association of a healthy lifestyle index including waist circumference with incident CVD in postmenopausal women with normal BMI remained to be examined.
Does adherence to a higher Healthy Lifestyle Index (HLI) reduce the risk of incident CVD in postmenopausal women with normal body mass index?
Cohort (n=40,118)
Does adherence to a higher Healthy Lifestyle Index (HLI) reduce the risk of incident CVD in postmenopausal women with normal body mass index?
Effect estimate: HR 0.48 (95% CI 0.43-0.54)
p-value: p=<0.001
Adherence to a healthy lifestyle significantly reduces the risk of incident CVD and its subtypes in postmenopausal women, even among those maintaining a normal body weight.
Supports lifestyle assessment in normal-BMI postmenopausal women; extends observational data but requires trial confirmation.
Background A lifestyle comprising a healthy diet, light alcohol consumption, no smoking, and moderate or intense physical activity has been associated with reduced risk of cardiovascular disease (CVD). We examined the association of a healthy lifestyle index (HLI), derived from scores for each of these components plus waist circumference, with the risk of incident CVD and CVD subtypes in postmenopausal women with normal body mass index (18.5–<25.0 kg/m 2 ). Methods and Results We studied 40 118 participants in the Women's Health Initiative, aged 50 to 79 years at enrollment, with a normal body mass index and no history of CVD. The HLI score was categorized into quintiles. We estimated multivariable adjusted hazard ratios (HR) and 95% CIs for the association of HLI with risk of CVD and CVD subtypes using Cox regression models. A total of 3821 cases of incident CVD were ascertained during a median follow‐up of 20.1 years. Compared with the lowest quintile (unhealthiest lifestyle), higher HLI quintiles showed inverse associations with the risk of CVD (HR quintile−2 =0.74 [95% CI, 0.67–0.81]; HR quintile−3 =0.66 [95% CI, 0.60–0.72]; HR quintile−4 =0.57 [95% CI, 0.51–0.63]; and HR quintile−5 =0.48 [95% CI, 0.43–0.54], P‐trend =<0.001). HLI was also inversely associated with risks of stroke, coronary heart disease, myocardial infarction, angina, and coronary revascularization. Subgroup analyses, stratified by age (≤63 years vs >63 years), body mass index (</≥ 22.0 kg/m 2 ), and general health status (absence/presence of hypertension, diabetes, or lipid‐lowering drug use) also showed inverse associations between HLI and risk of CVD. Conclusions Among postmenopausal women with a normal body mass index, adherence to a healthy lifestyle is associated with a reduced risk of clinical CVD and CVD subtypes, underscoring the cardiovascular benefits of maintaining a healthy lifestyle, even for women with a healthy weight.
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Peila et al. (2023) conducted a cohort in Cardiovascular disease prevention (n=40,118). Healthy lifestyle index (HLI) vs. Lowest quintile (unhealthiest lifestyle) was evaluated on Incident CVD (HR 0.48, 95% CI 0.43-0.54, p=<0.001). The highest quintile of a healthy lifestyle index reduced the risk of incident CVD compared to the lowest quintile in postmenopausal women with normal BMI (HR 0.48; 95% CI 0.43-0.54; P-trend <0.001).
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