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Cited by 266Cardiovascular Health and Risk FactorsNutritional Studies and DietHealth and Lifestyle Studies

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population

Open access
Lv, Jun, Yu, Canqing, Guo, Yu, Bian, Zheng, Yang, Ling, Chen, Yiping, Tang, Xuefeng, Zhang, Weiyuan, Qian, Yijian, Huang, Yuelong, Wang, Xiaoping, Chen, Junshi, Chen, Zhengming, Qi, Lu, Li, Liming, Chen, Junshi, Chen, Zhengming, Collins, Rory, Li, Liming, Peto, Richard, Avery, Daniel, Boxall, Ruth, Bennett, Derrick, Chang, Yumei, Chen, Yiping, Chen, Zhengming, Clarke, Robert, Du, Huaidong, Gilbert, Simon, Hacker, Alex, Holmes, Michael, Iona, Andri, Kartsonaki, Christiana, Kerosi, Rene, Kong, Ling, Kurmi, Om, Lancaster, Garry, Lewington, Sarah, Lin, Kuang, McDonnell, John, Mei, Winnie, Millwood, Iona, Nie, Qunhua, Radhakrishnan, Jayakrishnan, Rafiq, Sajjad, Ryder, Paul, Sansome, Sam, Schmidt, Dan, Sherliker, Paul, Sohoni, Rajani, Turnbull, Iain, Walters, Robin, Wang, Jenny, Wang, Lin, Yang, Ling, Yang, Xiaoming, Bian, Zheng, Chen, Ge, Guo, Yu, Han, Bingyang, Hou, Can, Lv, Jun, Pei, Pei, Qu, Shuzhen, Tan, Yunlong, Yu, Caning, Zhou, Haiyan, Pang, Zeng hang, Gao, Ruin, Wang, Shoji, Liu, Yong-Mei, Du, Ran ran, Zang, Yajing, Cheng, Liang, Tian, Xiaocao, Zhang, Hua, Lv, Silu, Wang, Junzheng, Hou, Wei, Yin, Jiyuan, Jiang, Ge, Zhou, Xue, Yang, Liqiu, He, Hui, Yu, Bo, Li, Yanjie, Mu, Huaiyi, Xu, Qinai, Dou, Meiling, Ren, Jiaojiao, Wang, Shanqing, Hu, Ximin, Wang, Hongmei, Chen, Jinyan, Fu, Yan, Fu, Zhenwang, Wang, Xiaohuan, Weng, Min, Zheng, Xiangyang, Li, Yilei, Li, Huimei, Wang, Yanjun, Wu, Ming, Zhou, Jinyi, Tao, Ran, Yang, Jie, Ni, Chuanming, Zhang, Jun, Hu, Yihe, Lu, Yan, Ma, Liangcai, Tang, Aiyu, Zhang, Shuo, Jin, Jianrong, Liu, Jingchao, Tang, Zhenzhu, Chen, Naying, Huang, Ying, Li, Mingqiang, Meng, Jinhuai, Pan, Rong, Jiang, Qilian, Zhang, Weiyuan, Liu, Yun, Wei, Liuping, Zhou, Liyuan, Chen, Ningyu, Guan, Hairong, Wu, Xianping, Zhang, Ningmei, Chen, Xiaofang, Tang, Xuefeng, Luo, Guojin, Li, Jianguo, Chen, Xiaofang, Zhong, Xunfu, Liu, Jiaqiu, Sun, Qiang, Ge, Pengfei, Ren, Xiaolan, Dong, Caixia, Zhang, Hui, Mao, Enke, Wang, Xiaoping, Wang, Tao, zhang, Xi, Zhang, Ding, Zhou, Gang, Feng, Shixian, Chang, Liang, Fan, Lei, Gao, Yulian, He, Tianyou, Sun, Huarong, He, Pan, Hu, Chen, Lv, Qiannan, Zhang, Xukui, Yu, Min, Hu, Ruying, Wang, Hao, Qian, Yijian, Wang, Chunmei, Xie, Kaixue, Chen, Lingli, Zhang, Yidan, Pan, Dongxia, Huang, Yuelong, Chen, Biyun, Yin, Li, Jin, Donghui, Liu, Huilin, Fu, Zhongxi, Xu, Qiaohua, Xu, Xin, Zhang, Hao, Xiong, Youping, Long, Huajun, Li, Xianzhi, Zhang, Libo, Qiu, Zhe·2017·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2016.11.076PMC PMC6675601
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Abstract

Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population. This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns. This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women. During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle. Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.

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  1. Chen, 2004, Department of Disease Control Ministry of Health, PR China. The guidelines for prevention and control of overweight and obesity in Chinese adults, Biomed Environ Sci, 17, 1

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Authors
Lv, J., Yu, C., Guo, Y., Bian, Z., Yang, L., Chen, Y., Tang, X., Zhang, W., Qian, Y., Huang, Y., Wang, X., Chen, J., Chen, Z., Qi, L., Li, L., Chen, J., Chen, Z., Collins, R., Li, L., Peto, R., Avery, D., Boxall, R., Bennett, D., Chang, Y., Chen, Y., Chen, Z., Clarke, R., Du, H., Gilbert, S., Hacker, A., Holmes, M., Iona, A., Kartsonaki, C., Kerosi, R., Kong, L., Kurmi, O., Lancaster, G., Lewington, S., Lin, K., McDonnell, J., Mei, W., Millwood, I., Nie, Q., Radhakrishnan, J., Rafiq, S., Ryder, P., Sansome, S., Schmidt, D., Sherliker, P., Sohoni, R., Turnbull, I., Walters, R., Wang, J., Wang, L., Yang, L., Yang, X., Bian, Z., Chen, G., Guo, Y., Han, B., Hou, C., Lv, J., Pei, P., Qu, S., Tan, Y., Yu, C., Zhou, H., Pang, Z. H., Gao, R., Wang, S., Liu, Y.-M., Du, R. R., Zang, Y., Cheng, L., Tian, X., Zhang, H., Lv, S., Wang, J., Hou, W., Yin, J., Jiang, G., Zhou, X., Yang, L., He, H., Yu, B., Li, Y., Mu, H., Xu, Q., Dou, M., Ren, J., Wang, S., Hu, X., Wang, H., Chen, J., Fu, Y., Fu, Z., Wang, X., Weng, M., Zheng, X., Li, Y., Li, H., Wang, Y., Wu, M., Zhou, J., Tao, R., Yang, J., Ni, C., Zhang, J., Hu, Y., Lu, Y., Ma, L., Tang, A., Zhang, S., Jin, J., Liu, J., Tang, Z., Chen, N., Huang, Y., Li, M., Meng, J., Pan, R., Jiang, Q., Zhang, W., Liu, Y., Wei, L., Zhou, L., Chen, N., Guan, H., Wu, X., Zhang, N., Chen, X., Tang, X., Luo, G., Li, J., Chen, X., Zhong, X., Liu, J., Sun, Q., Ge, P., Ren, X., Dong, C., Zhang, H., Mao, E., Wang, X., Wang, T., zhang, X., Zhang, D., Zhou, G., Feng, S., Chang, L., Fan, L., Gao, Y., He, T., Sun, H., He, P., Hu, C., Lv, Q., Zhang, X., Yu, M., Hu, R., Wang, H., Qian, Y., Wang, C., Xie, K., Chen, L., Zhang, Y., Pan, D., Huang, Y., Chen, B., Yin, L., Jin, D., Liu, H., Fu, Z., Xu, Q., Xu, X., Zhang, H., Xiong, Y., Long, H., Li, X., Zhang, L., & Qiu, Z.
Affiliations
  • Tulane University (US)
  • University of Oxford (GB)
  • Liu Zhou Center for Disease Prevention and Control (CN)
  • Peking University (CN)
  • Sichuan Center for Disease Control and Prevention (CN)
  • Hunan Provincial Center for Disease Control and Prevention (CN)
  • China National Center for Food Safety Risk Assessment (CN)
Corresponding author
Qi, Lu
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2017-03
Volume
69
Issue
9
Pages
1116-1125
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2016.11.076
PMC
PMC6675601
OpenAlex
W2591609485
Semantic Scholar
eab255a82b53a437583ba85f05c082e9daf61337
Cited by
266
References
31
Citations by year
2026: 13 · 2025: 40 · 2024: 30 · 2023: 42 · 2022: 40 · 2021: 41 · 2020: 23 · 2019: 14 · 2018: 13 · 2017: 9
FWCI
12.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Pure (Coventry University) (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (acceptedVersion)
Funders
  • Tulane University
  • Wellcome Trust (202922, 104085, 088158/Z/09/Z, 104085/Z/14/Z, 088158)
  • Cancer Research UK (A8760)
  • Peking University
  • Medical Research Council (MC_PC_14135)
  • Peking University Health Science Center
  • National Heart, Lung, and Blood Institute (R01HL071981, R21HL126024, R01HL132254, R01HL034594)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100383, R01DK091718, P30DK046200, R01DK078616, U01DK078616, UM1DK078616)
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 › Medicine › Public Health, Environmental and Occupational Health › Health and Lifestyle Studies
Keywords
healthy lifestyle adherence, cardiovascular risk, ischemic heart disease, ischemic stroke, modifiable risk factors, smoking, alcohol consumption, physical activity, fruit and vegetable intake, red meat consumption, body mass index, waist-to-hip ratio, coronary events, attributable fraction, China Kadoorie Biobank, Chinese population
MeSH terms
Healthy Lifestyle, Adult, Aged, Cardiovascular Diseases, China, Female, Humans, Male, Middle Aged, Patient Compliance, Cohort Studies, Health Behavior, Asian People

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