Department of Epidemiology (Z.Z., Y.J., D.G., K.Z., P.Y., L.S., M.S., Y.Z.), Suzhou Medical College of Soochow University, China.
Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine (F.-R.L.), Southern University of Science and Technology, China.
Circ Heart Fail. 2022 Sep;15(9):e009592. doi: 10.1161/CIRCHEARTFAILURE.122.009592. Epub 2022 Aug 17.
Whether lifestyle factors are similarly associated with risk of heart failure (HF) for individuals with different metabolic or genetic risk status remains unclear.
We included 464 483 participants from UK Biobank who were free of major cardiovascular disease or HF during baseline recruitment. Healthy lifestyle factors included avoidance of smoking, no obesity, regular physical activity, and healthy diet. Lifestyle was categorized as favorable (3 or 4 healthy lifestyle factors), intermediate (2 healthy lifestyle factors), and unfavorable (0 or 1 healthy lifestyle factor) lifestyles. Metabolic status was defined by the presence of hypertension, high total cholesterol, or diabetes at baseline. A weighted genetic risk score was created based on 12 single-nucleotide polymorphisms associated with HF.
Compared with favorable lifestyle, the multivariable-adjusted hazard ratios of HF were 1.79 (95% CI, 1.68-1.90) and 2.90 (95% CI, 2.70-3.11) for intermediate lifestyle and unfavorable lifestyle, respectively ( <0.0001). This association was largely consistent regardless of the presence of any single metabolic risk factor or the number of metabolic risk factors ( ≥0.21). The association was also similar across different genetic risk categories (=0.92). In a joint analysis, the hazard ratio of HF was 4.05 (95% CI, 3.43-4.77) comparing participants who had both higher genetic risk and an unfavorable lifestyle with those having lower genetic risk and a favorable lifestyle.
Combined lifestyle was associated with incident HF regardless of metabolic or genetic risk status, supporting the recommendation of healthy lifestyles for HF prevention across the entire population.
生活方式因素与代谢或遗传风险状态不同的个体心力衰竭（HF）风险的相关性是否相似尚不清楚。
我们纳入了英国生物库中 464483 名在基线招募时无主要心血管疾病或 HF 的参与者。健康的生活方式因素包括避免吸烟、不肥胖、经常进行体育锻炼和健康饮食。生活方式分为有利（有 3 或 4 个健康生活方式因素）、中等（有 2 个健康生活方式因素）和不利（有 0 或 1 个健康生活方式因素）生活方式。代谢状态根据基线时存在高血压、总胆固醇升高或糖尿病来定义。根据与 HF 相关的 12 个单核苷酸多态性创建了加权遗传风险评分。
与有利的生活方式相比，中间生活方式和不利的生活方式发生 HF 的多变量调整后的危险比分别为 1.79（95%CI，1.68-1.90）和 2.90（95%CI，2.70-3.11）（<0.0001）。这种关联在很大程度上是一致的，无论是否存在任何单一的代谢风险因素或存在多少个代谢风险因素（≥0.21）。这种关联在不同的遗传风险类别中也相似（=0.92）。在联合分析中，与遗传风险较低且生活方式有利的参与者相比，遗传风险较高且生活方式不利的参与者发生 HF 的危险比为 4.05（95%CI，3.43-4.77）。
无论代谢或遗传风险状态如何，综合生活方式与 HF 事件相关，支持在整个人群中推荐健康的生活方式以预防 HF。
