@article{JIANG2023, 
author = {Ying-Ying JIANG and Fang-Chao LIU and Chong SHEN and Jian-Xin LI and Ke-Yong HUANG and Xue-Li YANG and Ji-Chun CHEN and Xiao-Qing LIU and Jie CAO and Shu-Feng CHEN and Ling YU and Ying-Xin ZHAO and Xian-Ping WU and Lian-Cheng ZHAO and Ying LI and Dong-Sheng HU and Jian-Feng HUANG and Xiang-Feng LU and Dong-Feng GU},
title = {Lifestyle improvement and the reduced risk of cardiovascular disease: the China-PAR project},
year = {2023},
journal = {Journal of Geriatric Cardiology},
volume = {20},
number = {11},
pages = {779-787},
url = {https://www.sciopen.com/article/10.26599/1671-5411.2023.11.005},
doi = {10.26599/1671-5411.2023.11.005},
abstract = {BACKGROUND The benefits of healthy lifestyles are well recognized. However, the extent to which improving unhealthy lifestyles reduces cardiovascular disease (CVD) risk needs to be discussed. We evaluated the impact of lifestyle improvement on CVD incidence using data from the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China). METHODS A total of 12,588 participants free of CVD were followed up for three visits after the baseline examination. Changes in four lifestyle factors (LFs) (smoking, diet, physical activity, and alcohol consumption) were assessed through questionnaires from the baseline to the first follow-up visit. Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). The risk advancement periods (RAPs: the age difference between exposed and unexposed participants reaching the same incident CVD risk) and population-attributable risk percentage (PAR%) were also calculated. RESULTSA total of 909 incident CVD cases occurred over a median follow-up of 11.14 years. Compared with maintaining 0-1 healthy LFs, maintaining 3–4 healthy LFs was associated with a 40% risk reduction of incident CVD (HR = 0.60, 95% CI: 0.45–0.79) and delayed CVD risk by 6.31 years (RAP: −6.31 [−9.92, −2.70] years). The PAR% of maintaining 3–4 unhealthy LFs was 22.0% compared to maintaining 0-1 unhealthy LFs. Besides, compared with maintaining two healthy LFs, improving healthy LFs from 2 to 3–4 was associated with a 23% lower risk of CVD (HR = 0.77, 95% CI: 0.60–0.98). CONCLUSIONSLong-term sustenance of healthy lifestyles or improving unhealthy lifestyles can reduce and delay CVD risk.}
}