Lv Jun, Yu Canqing, Guo Yu, Bian Zheng, Yang Ling, Chen Yiping, Tang Xuefeng, Zhang Weiyuan, Qian Yijian, Huang Yuelong, Wang Xiaoping, Chen Junshi, Chen Zhengming, Qi Lu, Li Liming
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Peking University Institute of Environmental Medicine, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
J Am Coll Cardiol. 2017 Mar 7;69(9):1116-1125. doi: 10.1016/j.jacc.2016.11.076.
Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.
This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.
This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m, and a waist-to-hip ratio <0.90 for men and <0.85 for women.
During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle.
Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.
坚持多种健康生活方式因素与白人人群心血管风险的显著降低相关；然而，对于亚洲人群等非白人人群中这种关联是否持续存在，人们了解甚少。
本研究旨在探讨可改变的多种健康生活方式因素与缺血性心血管疾病风险之间的关联，并估计通过坚持这些健康生活方式模式可能预防的疾病比例。
本研究在中国嘉道理生物银行的461211名30至79岁的参与者中，研究了6种生活方式因素与缺血性心脏病和缺血性中风（IS）之间的关联，这些参与者在基线时没有心血管疾病、癌症或糖尿病。低风险生活方式因素定义为不吸烟状态或因非疾病原因戒烟、每日酒精摄入量<30克、中等或更高水平的体力活动、富含蔬菜和水果且红肉摄入量有限的饮食、体重指数为18.5至23.9千克/米²，男性腰臀比<0.90，女性腰臀比<0.85。
在中位7.2年（330万人年）的随访期间，本研究记录了3331例新发主要冠状动脉事件（MCE）和19348例新发IS。在多变量调整分析中，当前不吸烟状态、轻度至中度饮酒、高体力活动、富含蔬菜和水果且红肉摄入量有限的饮食以及低肥胖与MCE和IS风险降低独立相关。与没有任何低风险因素的参与者相比，具有≥4种低风险因素的参与者发生MCE的风险比为0.42（95%置信区间：0.34至0.52），发生IS的风险比为0.61（95%置信区间：0.56至0.66）。大约67.9%（95%置信区间：46.5%至81.9%）的MCE和39.1%（95%置信区间：26.4%至50.4%）的IS病例可归因于对健康生活方式的不良坚持。
坚持健康生活方式可能会大幅降低中国人的心血管疾病负担。
