Format

Send to

Choose Destination
J Am Heart Assoc. 2018 Dec 4;7(23):e010405. doi: 10.1161/JAHA.118.010405.

Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women's Health Across the Nation.

Author information

1
1 Department of Epidemiology University of Michigan Ann Arbor MI.
2
2 Division of Cardiovascular Disease University of Alabama at Birmingham AL.
3
3 Department of Biostatistics University of Michigan Ann Arbor MI.
4
4 Survey Research Center University of Michigan Ann Arbor MI.
5
5 Department of Neurology Albert Einstein College of Medicine Bronx NY.
6
6 Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY.
7
7 Division of Research Kaiser Permanente Oakland CA.
8
8 Department of Preventive Medicine Rush University Medical Center Chicago IL.
9
9 Medical School University of Massachusetts Worcester MA.
10
10 Division of Geriatrics University of California Los Angeles Los Angeles CA.
11
11 Department of Epidemiology University of Pittsburgh PA.
12
12 Cardiology Division Massachusetts General Hospital Boston MA.
13
13 Department of Nutritional Sciences University of Michigan Ann Arbor MI.

Abstract

Background Measures of subclinical atherosclerosis are predictors of future cardiovascular outcomes as well as of physical and cognitive functioning. The menopausal transition is associated with accelerated progression of atherosclerosis in women. The prospective association between a healthy lifestyle during the midlife and subclinical atherosclerosis is unclear. Methods and Results Self-reported data on smoking, diet, and physical activity from 1143 women in the Study of Women's Health Across the Nation were used to construct a 10-year average Healthy Lifestyle Score ( HLS ) during the midlife. Markers of subclinical atherosclerosis were measured 14 years after baseline and included common carotid artery intima-media thickness ( CCA - IMT ), adventitial diameter ( CCA - AD ), and carotid plaque. The associations of average HLS with CCA - IMT and CCA - AD were estimated using linear models; the association of average HLS with carotid plaque was estimated using cumulative logit models. Average HLS was associated with smaller CCA - IMT and CCA - AD in the fully adjusted models ( P=0.0031 and <0.001, respectively). Compared with participants in the lowest HLS level, those in the highest level had 0.024 mm smaller CCA - IMT (95% confidence interval: -0.048, 0.000), which equals 17% of the SD of CCA - IMT , and 0.16 mm smaller CCA - AD (95% confidence interval: -0.27, -0.04), which equals 24% of the SD of CCA - AD . Among the 3 components of the HLS , abstinence from smoking had the strongest association with subclinical atherosclerosis. Conclusions Healthy lifestyle during the menopausal transition is associated with less subclinical atherosclerosis, highlighting the growing recognition that the midlife is a critical window for cardiovascular prevention in women.

KEYWORDS:

atherosclerosis; cardiovascular disease; lifestyle; risk factors; women

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center