October 17, 2022Open Access
Effects of lifestyle risk behaviour clustering on cardiovascular disease among UK adults: latent class analysis with distal outcomes
Key Result
Adults with a cluster of three lifestyle risk behaviors (physical inactivity, poor fruit and vegetable intake, and high alcohol intake) had 25.18 higher odds of having cardiovascular disease compared to those with two risk behaviors.
Study Design
Type
Cross-Sectional (n=283,172)
Multicenter
Yes
Structured PICO
Does the clustering of multiple lifestyle risk behaviours increase cardiovascular disease and CVD risk in UK adults?
P
Population
283,172 middle-aged UK adults (38-73 years) with data on cardiovascular disease status and lifestyle risk behaviors, analyzed cross-sectionally to assess the impact of lifestyle risk behavior clustering.
E
Exposure
Clustering of multiple lifestyle risk behaviours (physical inactivity, poor fruit & vegetable intake, high alcohol intake, prolonged sitting, poor sleep, smoking) assessed via latent class analysis.
C
Comparator
Fewer or single lifestyle risk behaviours (e.g., high alcohol intake alone, or two risk behaviours).
O
Outcome
Cardiovascular disease (CVD) status (physician diagnosis of heart attack, angina, stroke, or high blood pressure) and 10-year CVD risk score (Framingham).composite
Clustering of multiple lifestyle risk behaviors significantly increases the odds of having cardiovascular disease and the 10-year CVD risk among UK adults.
Main Result
Odds Ratio: 25.18 (95% CI 7.02–43.33)
Limitations
- Self-reported questionnaires for lifestyle risk behaviors may introduce recall or social desirability bias.
- Measures of several lifestyle risk behaviors were under-specified, such as sleep quantity without quality.
- Smoking measure did not consider past smoking history.
Abstract
Lifestyle risk behaviours such as smoking, physical inactivity, and unhealthy diet account for a considerable disease burden globally. These risk behaviours tend to cluster within an individual, which could have detrimental health effects. In this study, we aimed to examine the clustering effect of lifestyle risk behaviours on cardiovascular disease (CVD) and CVD risk among adults in the United Kingdom (UK). We performed a latent class (LC) analysis with distal outcomes using the UK Biobank baseline (2006-2010) data. First, we estimated LC measurement models, followed by an auxiliary model conditional on LC variables. We reported continuous (mean difference-MD) and binary (odds ratio-OR) outcomes with 95% confidence intervals. We included 283,172 and 174,030 UK adults who had data on CVD and CVD risk, respectively. Multiple lifestyle risk behaviour clustering (physically inactive, poor fruit & vegetable intake, high alcohol intake, and prolonged sitting) had a 3.29 mean increase in CVD risk compared to high alcohol intake. In addition, adults with three risk behaviours (physically inactive, poor fruit & vegetable intake, and high alcohol intake) had 25.18 higher odds of having CVD than those with two risk behaviours (physically inactive, and poor fruit and vegetable intake). Social deprivation, gender and age were also associated with CVD. Individuals' LC membership with two or more lifestyle risk behaviours negatively affects CVD. Interventions targeting multiple lifestyle behaviours and social circumstances should be prioritized to reduce the CVD burden.