Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis y Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; CIBER-CV.
J Clin Lipidol. 2018 May-Jun;12(3):615-625. doi: 10.1016/j.jacl.2018.03.081. Epub 2018 Mar 28.
Public health strategies targeting multiple healthy behaviors, rather than individual factors, have been proposed as more efficient strategies to promote cardiovascular health. However, the additive effect of multiple targets on primary prevention has not been fully characterized.
To examine how adherence to multiple healthy behaviors is associated with the presence of subclinical atherosclerosis, a measure of early cardiovascular disease.
Analysis of a baseline data from 1798 middle-aged men from the Aragon Workers Health Study conducted between 2009 and 2010. Healthy behaviors were defined according to American Heart Association recommendations, aligned with Spanish Nutritional recommendations and included moderate alcohol consumption, smoking abstinence, no abdominal adiposity, decreased sedentarism, and adherence to Alternate Mediterranean Dietary Index. Presence of coronary artery calcium and plaques in femoral and carotid was quantified by a 16-slice computed tomography scanner and 2D ultrasound.
Moderate alcohol consumption, as well as adherence to Mediterranean diet is independently associated with a 6% lower risk of having subclinical atherosclerosis. Smoking abstinence is associated with a 11% lower risk of subclinical atherosclerosis. Those who follow 3 lifestyle behaviors (Mediterranean diet, nonsmoking, and moderate alcohol intake) have 18% lower odds of presenting subclinical atherosclerosis compared with those who do not follow these protective lifestyle habits.
Adoption of multiple healthy lifestyle behaviors early in life could be a key strategy to tackle the onset of atherosclerosis and reduce cardiovascular disease burden.
针对多种健康行为的公共卫生策略，而不是针对个别因素，已被提议为促进心血管健康的更有效策略。然而，多个目标对初级预防的附加效果尚未得到充分描述。
研究多种健康行为的依从性与亚临床动脉粥样硬化（心血管疾病早期的一种衡量标准）之间的关系。
对 2009 年至 2010 年期间进行的阿拉贡工人健康研究中 1798 名中年男性的基线数据进行分析。健康行为根据美国心脏协会的建议定义，与西班牙营养建议一致，包括适量饮酒、不吸烟、无腹部肥胖、减少久坐不动和遵守交替地中海饮食指数。通过 16 层计算机断层扫描和 2D 超声来量化冠状动脉钙和股动脉及颈动脉斑块的存在。
适量饮酒以及遵循地中海饮食与亚临床动脉粥样硬化的风险降低 6%独立相关。不吸烟与亚临床动脉粥样硬化的风险降低 11%相关。与不遵循这些保护生活方式习惯的人相比，遵循 3 种生活方式行为（地中海饮食、不吸烟和适量饮酒）的人发生亚临床动脉粥样硬化的几率降低 18%。
在生命早期采用多种健康的生活方式可能是解决动脉粥样硬化发病和降低心血管疾病负担的关键策略。
