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Circulation. 2014 Jul 1;130(1):10-7. doi: 10.1161/CIRCULATIONAHA.113.005445. Epub 2014 Apr 28.

Healthy lifestyle change and subclinical atherosclerosis in young adults: Coronary Artery Risk Development in Young Adults (CARDIA) study.

Author information

  • 1From the Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (B.S., A.C.M., L.A.C., J.S., M.R., M.L.D., K.L.); Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); and Division of Research, Kaiser Permanente Northern California, Oakland, CA (S.S.). bspring@northwestern.edu.
  • 2From the Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (B.S., A.C.M., L.A.C., J.S., M.R., M.L.D., K.L.); Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); and Division of Research, Kaiser Permanente Northern California, Oakland, CA (S.S.).

Abstract

BACKGROUND:

The benefits of healthy habits are well established, but it is unclear whether making health behavior changes as an adult can still alter coronary artery disease risk.

METHODS AND RESULTS:

The Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study (n=3538) assessed 5 healthy lifestyle factors (HLFs) among young adults aged 18 to 30 years (year 0 baseline) and 20 years later (year 20): not overweight/obese, low alcohol intake, healthy diet, physically active, nonsmoker. We tested whether change from year 0 to 20 in a continuous composite HLF score (HLF change; range, -5 to +5) is associated with subclinical atherosclerosis (coronary artery calcification and carotid intima-media thickness) at year 20, after adjustment for demographics, medications, and baseline HLFs. By year 20, 25.3% of the sample improved (HLF change ≥+1); 40.4% deteriorated (had fewer HLFs); 34.4% stayed the same; and 19.2% had coronary artery calcification (>0). Each increase in HLFs was associated with reduced odds of detectable coronary artery calcification (odds ratio=0.85; 95% confidence interval, 0.74-0.98) and lower intima-media thickness (carotid bulb β=-0.024, P=0.001), and each decrease in HLFs was predictive to a similar degree of greater odds of coronary artery calcification (odds ratio=1.17; 95% confidence interval, 1.02-1.33) and greater intima-media thickness (β=+0.020, P<0.01).

CONCLUSIONS:

Healthy lifestyle changes during young adulthood are associated with decreased risk and unhealthy lifestyle changes are associated with increased risk for subclinical atherosclerosis in middle age.

© 2014 American Heart Association, Inc.

KEYWORDS:

behavior modification; behavioral medicine; cardiovascular diseases; epidemiology; follow-up study; prevention; risk factors

PMID:
24982115
[PubMed - indexed for MEDLINE]
PMCID:
PMC4615574
Free PMC Article
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