Maintaining a healthy lifestyle compared with a persistently unhealthy lifestyle significantly lowered the risk of all-cause mortality (HR 0.48; 95% CI 0.36-0.63) in patients with established CVD.
Cohort (n=2,011)
Does maintaining or improving a healthy lifestyle reduce mortality and incident Type 2 diabetes in patients with established cardiovascular disease?
Maintaining or adopting a healthy lifestyle significantly lowers the risk of all-cause mortality, cardiovascular mortality, and incident Type 2 diabetes in patients with established cardiovascular disease.
Hazard Ratio: 0.48 (95% CI 0.36–0.63)
AIMS: To quantify the relationship between self-reported, long-term lifestyle changes (smoking, waist circumference, physical activity, and alcohol consumption) and clinical outcomes in patients with established cardiovascular disease (CVD). METHODS AND RESULTS: Data were used from 2011 participants (78% male, age 57 ± 9 years) from the Utrecht Cardiovascular Cohort-Second Manifestations of ARTerial disease cohort who returned for a re-assessment visit (SMART2) after ∼10 years. Self-reported lifestyle change was classified as persistently healthy, improved, worsened, or persistently unhealthy. Cox proportional hazard models were used to quantify the relationship between lifestyle changes and the risk of (cardiovascular) mortality and incident Type 2 diabetes (T2D). Fifty-seven per cent of participants was persistently healthy, 17% improved their lifestyle, 8% worsened, and 17% was persistently unhealthy. During a median follow-up time of 6.1 (inter-quartile range 3.6-9.6) years after the SMART2 visit, 285 deaths occurred, and 99 new T2D diagnoses were made. Compared with a persistently unhealthy lifestyle, individuals who maintained a healthy lifestyle had a lower risk of all-cause mortality hazard ratio (HR) 0.48, 95% confidence interval (CI) 0.36-0.63, cardiovascular mortality (HR 0.57, 95% CI 0.38-0.87), and incident T2D (HR 0.46, 95% CI 0.28-0.73). Similarly, those who improved their lifestyle had a lower risk of all-cause mortality (HR 0.52, 95% CI 0.37-0.74), cardiovascular mortality (HR 0.46, 95% CI 0.26-0.81), and incident T2D (HR 0.50, 95% CI 0.27-0.92). CONCLUSION: These findings suggest that maintaining or adopting a healthy lifestyle can significantly lower mortality and incident T2D risk in CVD patients. This study emphasizes the importance of ongoing lifestyle optimization in CVD patients, highlighting the potential for positive change regardless of previous lifestyle habits.
Bonekamp et al. (Fri,) conducted a cohort in established cardiovascular disease (CVD) (n=2,011). Maintaining a healthy lifestyle vs. Persistently unhealthy lifestyle was evaluated on all-cause mortality (HR 0.48, 95% CI 0.36-0.63). Maintaining a healthy lifestyle compared with a persistently unhealthy lifestyle significantly lowered the risk of all-cause mortality (HR 0.48; 95% CI 0.36-0.63) in patients with established CVD.