Impact of a Comprehensive Healthy Lifestyle Score on a Broad Spectrum of Cardiometabolic Diseases and Enhanced Risk Prediction Based on the UK Biobank Database
Abstract Body (Do not enter title and authors here): Background: Cardiometabolic diseases (CMDs) represent a major global disease burden. While traditional risk factors are well-established, the role of lifestyle factorsin primary prevention has not been sufficiently studied.
Methods: We analyzed data from 148,155 participants in the UK Biobank without baseline CMD. Cox proportional hazards models were used to assess the impact of healthy lifestyle factors (non-smoking, moderate alcohol consumption, regular physical activity, healthy diet, and healthy sleep) on 11 types of CMDs(coronary heart disease, type 2 diabetes, atrial fibrillation, hypertension, stroke, heart failure, Alzheimer's disease, non-alcoholic fatty liver disease, valvular heart disease, cardiomyopathy, and pulmonary hypertension). Participants were categorized into four groups based on weighted lifestyle scores. Improvements in predictive models after incorporating lifestyle factors were evaluated.
Results: Each healthy lifestyle factor significantly reduced the risk of CMD, with healthy sleep contributing the most (β=0.342). Adhering to a healthier lifestyle demonstrated a significant and dose-response association with a reduced risk of composite CMDs. In the fully adjusted model, compared to the "very unhealthy" group, the "very healthy" group exhibited a significantly lower risk of developing CMDs (HR: 0.70, 95% CI: 0.67–0.74). This protective association was observed across most individual CMDs, with the most pronounced effect seen in pulmonary arterial hypertension ( HR: 0.34, 95% CI: 0.24–0.50). Incorporating the lifestyle score into traditional risk models improved their predictive performance. The findings remained consistent across various subgroups and proved robust in sensitivity analyses.
Conclusion: This study systematically reveals that a healthy lifestyle is associated with a significant reduction in the risk of a wide range of CMDs, and it enhances the accuracy of existing risk prediction models. This underscores its critical role in the primary prevention of cardiovascular and metabolic diseases.
Song, Yanjun
( Fuwai hospital
, Beijing
, China
)
Chen, Xinyue
( Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
, Beijing
, China
)
Zheng, Zhihao
( Fuwai Hospital
, Beijing
, China
)
Bian, Xiaohui
( Fuwai Hospital
, Beijing
, China
)
Lin, Zhangyu
( Fuwai Hospital
, Beijing
, China
)
Author Disclosures:
Yanjun Song:DO NOT have relevant financial relationships
| Xinyue Chen:DO NOT have relevant financial relationships
| Zhihao Zheng:DO NOT have relevant financial relationships
| Xiaohui Bian:DO NOT have relevant financial relationships
| Zhangyu Lin:DO NOT have relevant financial relationships
