July 5, 2006Circulation483 citationsOpen Access
Healthy Lifestyle Factors in the Primary Prevention of Coronary Heart Disease Among Men
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Structured PICO
Does adherence to healthy lifestyle factors reduce the risk of incident CHD in middle-aged and older US men?
P
Population
42,847 US men in the Health Professionals Follow-up Study, 40 to 75 years of age and free of disease in 1986.
I
Intervention
Adherence to 5 healthy lifestyle factors (absence of smoking, BMI <25 kg/m2, moderate-to-vigorous activity >= 30 min/d, moderate alcohol consumption 5 to 30 g/d, and top 40% of healthy diet score).
C
Comparator
Men at low risk for no lifestyle factors.
O
Outcome
Incident cases of CHD (nonfatal myocardial infarction and fatal CHD) over 16 years.hard clinical
Adherence to five healthy lifestyle practices may prevent a majority of CHD events among US men, including those on medications for hypertension or hypercholesterolemia.
Abstract
BACKGROUND: Healthy lifestyle choices such as eating a prudent diet, exercising regularly, managing weight, and not smoking may substantially reduce coronary heart disease (CHD) risk by improving lipids, blood pressure, and other risk factors. The burden of CHD that could be avoided through adherence to these modifiable lifestyle factors has not been assessed among middle-aged and older US men, specifically men taking medications for hypertension or hypercholesterolemia. METHODS AND RESULTS: We prospectively monitored 42 847 men in the Health Professionals Follow-up Study, 40 to 75 years of age and free of disease in 1986. Lifestyle factors were updated through self-reported questionnaires. Low risk was defined as (1) absence of smoking, (2) body mass index or = 30 min/d, (4) moderate alcohol consumption (5 to 30 g/d), and (5) the top 40% of the distribution for a healthy diet score. Over 16 years, we documented 2183 incident cases of CHD (nonfatal myocardial infarction and fatal CHD). In multivariate-adjusted Cox proportional hazards models, men who were at low risk for 5 lifestyle factors had a lower risk of CHD (relative risk: 0.13; 95% confidence interval CI: 0.09, 0.19) compared with men who were at low risk for no lifestyle factors. Sixty-two percent (95% CI: 49%, 74%) of coronary events in this cohort may have been prevented with better adherence to these 5 healthy lifestyle practices. Among men taking medication for hypertension or hypercholesterolemia, 57% (95% CI: 32%, 79%) of all coronary events may have been prevented with a low-risk lifestyle. Compared with men who did not make lifestyle changes during follow-up, those who adopted > or = 2 additional low-risk lifestyle factors had a 27% (95% CI: 7%, 43%) lower risk of CHD. CONCLUSIONS: A majority of CHD events among US men may be preventable through adherence to healthy lifestyle practices, even among those taking medications for hypertension or hypercholesterolemia.
Cite This Study
Chiuve et al. (2006) studied this question.