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June 24, 2026American Journal of Preventive MedicineOpen Access

The Lifestyle Medicine Health Behavior Scale and Cardiovascular Disease: A Prospective Cohort Study From the UK Biobank

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Why the study?

Does higher adherence to healthy lifestyle behaviors, as measured by the modified Lifestyle Medicine Health Behavior scale, reduce the risk of cardiovascular disease in adults without baseline CVD?

Population

447,311 individuals aged 40-70 years from the UK Biobank who were free of cardiovascular disease at baseline.

Comparison

Highest quintile of the modified Lifestyle… vs Lowest quintile of the modified Lifestyle…

Design

Cohort

Follow-up

12.55-year median

Key result

Being in the highest quintile of the modified Lifestyle Medicine Health Behavior score was associated with a lower risk of cardiovascular disease (HR 0.66; 95% CI 0.63-0.70; p-trend <0.001).

Authors

MSMercedes Sotos‐PrietoJMJavier Maroto-RodríguezJPJulia Pangalangan

Discussion

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Overview

Supports lower CVD risk with higher lifestyle scores in large cohort; extends observational links but leaves causal effects open for trials.

Key Points

  • This study aims to evaluate the relationship between the modified Lifestyle Medicine Health Behavior scale and cardiovascular disease risk.
  • Analyzed data from 447,311 individuals aged 40-70 from the UK Biobank, free of cardiovascular disease at baseline.
  • Calculated the modified Lifestyle Medicine Health Behavior scale score based on self-reported lifestyle factors over a median follow-up of 12.55 years.
  • Applied multivariable Cox regression models to assess the association between lifestyle scores and cardiovascular disease incidence.
  • 16,168 cardiovascular disease events occurred during follow-up.
  • Participants in the highest quintile of lifestyle scores had a hazard ratio of 0.66 for cardiovascular disease compared to the lowest quintile (95% CI 0.63, 0.70).
  • Substance use and sleep were the strongest factors associated with reduced cardiovascular disease risk.

Study Design

Type

Cohort (n=447,311)

Structured PICO

Does higher adherence to healthy lifestyle behaviors, as measured by the modified Lifestyle Medicine Health Behavior scale, reduce the risk of cardiovascular disease in adults without baseline CVD?

P
Population
447,311 individuals aged 40-70 years from the UK Biobank who were free of cardiovascular disease at baseline.
I
Intervention
Highest quintile of the modified Lifestyle Medicine Health Behavior (LMHB) scale score (assessing nutrition, physical activity, sleep, stress management, social connection, and substance use).
C
Comparator
Lowest quintile of the modified Lifestyle Medicine Health Behavior (LMHB) scale score.
O
Outcome
Cardiovascular disease incidence (defined as primary myocardial infarction or stroke).hard clinical

Main Result

Effect estimate: HR 0.66 (95% CI 0.63-0.70)

p-value: p=<0.001

A higher score on the comprehensive Lifestyle Medicine Health Behavior scale is strongly associated with a lower risk of incident cardiovascular disease, myocardial infarction, and stroke.

Cite This Study

Sotos‐Prieto et al. (2026) conducted a cohort in Free of cardiovascular disease (n=447,311). Modified Lifestyle Medicine Health Behavior scale (highest quintile) vs. Lowest quintile was evaluated on Cardiovascular disease incidence (primary myocardial infarction or stroke) (HR 0.66, 95% CI 0.63-0.70, p=<0.001). Being in the highest quintile of the modified Lifestyle Medicine Health Behavior score was associated with a lower risk of cardiovascular disease (HR 0.66; 95% CI 0.63-0.70; p-trend <0.001).

synapsesocial.com/papers/6a3c2375d15afadd906fa314https://doi.org/10.1016/j.amepre.2026.108416
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