AUTHOR=Su Jian , Geng Houyue , Chen Lulu , Fan Xikang , Zhou Jinyi , Wu Ming , Lu Yan , Hua Yujie , Jin Jianrong , Guo Yu , Lv Jun , Pei Pei , Chen Zhengming , Tao Ran 

TITLE=Association of healthy lifestyle with incident cardiovascular diseases among hypertensive and normotensive Chinese adults

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1046943

DOI=10.3389/fcvm.2023.1046943

ISSN=2297-055X

ABSTRACT=Background: Whether lifestyle improvement benefits in reducing cardiovascular disease (CVD) events extend to hypertensive patients and whether these benefits differ between hypertensive and normotensive individuals is unclear. This study aimed to investigate the associations of an overall healthy lifestyle with the subsequent development of CVDs among participants with hypertension and normotension.
Methods: This study examined the associations of 5 lifestyle factors with total CVD, ischemic heart disease (IHD) and ischemic stroke (IS) in the Suzhou subcohort of the China Kadoorie Biobank study of 51,929 participants. We defined five healthy lifestyle factors as nonsmoking or smoking cessation not due to illness; nonexcessive alcohol intake; median or higher level of physical activity; a relatively healthy diet; and having a standard body mass index and waist circumference.
Results: During a follow-up of 10.1 years, this study documented 6,152 incident total CVD events, 1,304 incident IHD events, and 2,244 incident IS events. Compared to those with 0-1 healthy lifestyle factors, HRs for those with 4-5 healthy factors were 0.73 (95% CI: 0.64, 0.84) for total CVD, 0.55 (95% CI: 0.41, 0.74) for IHD, and 0.67 (95% CI: 0.54, 0.84) for IS among hypertensive participants. However, we did not observe this association among normotensive participants. Stratified analyses showed that the association between a healthy lifestyle and IHD risk was stronger among younger participants, and the association with IS risk was stronger among adults with lower household incomes among hypertensive individuals.
Conclusions: Adherence to a healthy lifestyle pattern is associated with a lower risk of cardiovascular diseases among hypertensive patients, but this benefit is not as pronounced among normotensive patients.