Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease Among Young Women
Open accessAbstract
Background Overall mortality rates from coronary heart disease (CHD) in the United States have declined in recent decades, but the rate has plateaued among younger women. The potential for further reductions in mortality rates among young women through changes in lifestyle is unknown.Objectives The aim of this study was to estimate the proportion of CHD cases and clinical cardiovascular disease (CVD) risk factors among young women that might be attributable to poor adherence to a healthy lifestyle.Methods A prospective analysis was conducted among 88,940 women ages 27 to 44 years at baseline in the Nurses' Health Study II who were followed from 1991 to 2011. Lifestyle factors were updated repeatedly by questionnaire. A healthy lifestyle was defined as not smoking, a normal body mass index, physical activity ≥ 2.5 h/week, television viewing ≤ 7 h/week, diet in the top 40% of the Alternative Healthy Eating Index-2010, and 0.1 to 14.9 g/day of alcohol. To estimate the proportion of CHD and clinical CVD risk factors (diabetes, hypertension, and hypercholesterolemia) that could be attributed to poor adherence to a healthy lifestyle, we calculated the population-attributable risk percent.Results During 20 years of follow-up, we documented 456 incident CHD cases. In multivariable-adjusted models, nonsmoking, a healthy body mass index, exercise, and a healthy diet were independently and significantly associated with lower CHD risk. Compared with women with no healthy lifestyle factors, the hazard ratio for CHD for women with 6 lifestyle factors was 0.08 (95% confidence interval: 0.03 to 0.22). Approximately 73% (95% confidence interval: 39% to 89%) of CHD cases were attributable to poor adherence to a healthy lifestyle. Similarly, 46% (95% confidence interval: 43% to 49%) of clinical CVD risk factor cases were attributable to a poor lifestyle.Conclusions Primordial prevention through maintenance of a healthy lifestyle among young women may substantially lower the burden of CVD.
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People who adhere to a healthy lifestyle have markedly reduced rates of incident cardiovascular events.
“Much evidence has also shown that persons who adhere to a healthy lifestyle have markedly reduced rates of incident cardiovascular events.25–30”
From Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease (2016) · cites this paper as [29]
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- Authors
- Chomistek, A. K., Chiuve, S. E., Eliassen, A. H., Mukamal, K. J., Willett, W. C., & Rimm, E. B.
- Affiliations
- Indiana University Bloomington (US)
- Brigham and Women's Hospital (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Chomistek, Andrea K.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 65
- Issue
- 1
- Pages
- 43-51
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC4291551
- OpenAlex
- W1974713100
- Cited by
- 283
- References
- 45
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 21 · 2023: 22 · 2022: 23 · 2021: 34 · 2020: 25 · 2019: 23 · 2018: 22 · 2017: 43 · 2016: 25 · 2015: 10
- FWCI
- 24.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (UM1-CA-176726, CA176726, DK007703)
- National Cancer Institute (UM1CA176726, CA176726, R01CA050385)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK007703., T32DK007703)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Keywords
- healthy lifestyle, coronary artery disease, young women, primordial prevention, cardiovascular risk factors, population attributable risk, physical activity, diet, body mass index, smoking, television viewing, alcohol consumption, diabetes mellitus, hypertension, hypercholesterolemia, Nurses' Health Study II
- MeSH terms
- Adult, Coronary Disease, Female, Humans, Life Style, Primary Prevention, Prospective Studies, Risk Factors, Health Behavior, Multivariate Analysis, Proportional Hazards Models
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