Healthy Lifestyle Through Young Adulthood and the Presence of Low Cardiovascular Disease Risk Profile in Middle Age: The Coronary Artery Risk Development in (Young) Adults (CARDIA) Study
Open accessAbstract
Background—: A low cardiovascular disease risk profile (untreated cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, never smoking, and no history of diabetes mellitus or myocardial infarction) in middle age is associated with markedly better health outcomes in older age, but few middle-aged adults have this low risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with the presence of the low cardiovascular disease risk profile in middle age. Methods and Results—: The Coronary Artery Risk Development in (Young) Adults (CARDIA) study sample consisted of 3154 black and white participants 18 to 30 years of age at year 0 (1985–1986) who attended the year 0, 7, and 20 examinations. Healthy lifestyle factors defined at years 0, 7, and 20 included average body mass index <25 kg/m 2 , no or moderate alcohol intake, higher healthy diet score, higher physical activity score, and never smoking. Mean age (25 years) and percentage of women (56%) were comparable across groups defined by number of healthy lifestyle factors. The age-, sex-, and race-adjusted prevalences of low cardiovascular disease risk profile at year 20 were 3.0%, 14.6%, 29.5%, 39.2%, and 60.7% for people with 0 or 1, 2, 3, 4, and 5 healthy lifestyle factors, respectively ( P for trend <0.0001). Similar graded relationships were observed for each sex-race group (all P for trend <0.0001). Conclusions—: Maintaining a healthy lifestyle throughout young adulthood is strongly associated with a low cardiovascular disease risk profile in middle age. Public health and individual efforts are needed to improve the adoption and maintenance of healthy lifestyles in young adults.
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Prevention lowers the impact of cardiovascular disease.
“Prevention is effective in reducing the impact of CVD”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [3]
Removing health risk behaviours could prevent at least 80% of cardiovascular disease and 40% of cancers.
“the elimination of health risk behaviours would make it possible to prevent at least 80% of CVD and even 40% of cancers”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [3]
Eliminating health risk behaviours could prevent at least 80% of cardiovascular disease and 40% of cancers.
“the elimination of health risk behaviours would make it possible to prevent at least 80% of CVD and even 40% of cancers, thus providing added value for other chronic diseases.3,4”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [3]
Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) study demonstrate that young adults aged 18 to 30 years with healthy behaviors grow up to become older adults with lower biological risk.
“Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) study demonstrate that young adults aged 18 to 30 years with healthy behaviors grow up to become older adults with lower biological risk.12”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [12]
CARDIA participants who did not have a healthy lifestyle at baseline but began to practice healthy behaviors later still had higher rates of ideal cardiovascular biomarkers than those who never adopted healthy behaviors.
“Moreover, highlighting the promise of behavior change, those who did not have a healthy lifestyle at baseline but began to practice healthy behaviors later still had higher rates of ideal cardiovascular biomarkers than those who never adopted healthy behaviors.”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [12]
Regardless of timing, the adoption of a healthy lifestyle has value for cardiovascular health.
“These results indicate that regardless of timing, the adoption of a healthy lifestyle has value for cardiovascular health.12”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [12]
Among CARDIA participants who practiced all 5 healthy lifestyle behaviors in young adulthood, 60% had all ideal cardiovascular biomarkers in middle age.
“Among those who practiced all of 5 healthy lifestyle behaviors in young adulthood (nonsmoking, low or no alcohol use, healthy diet, physically active, maintenance of normal weight), 60% had all ideal cardiovascular biomarkers in middle age.”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [12]
Of CARDIA participants who practiced none of these healthy behaviors in young adulthood, fewer than 5% reached middle age with all cardiovascular biomarkers at ideal levels.
“In contrast, of those who practiced none of these healthy behaviors in young adulthood, fewer than 5% reached middle age with all cardiovascular biomarkers at ideal levels.12”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [12]
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- Authors
- Liu, K., Daviglus, M. L., Loria, C. M., Colangelo, L. A., Spring, B., Moller, A. C., & Lloyd-Jones, D. M.
- Affiliations
- Northwestern University (US)
- From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L., M.L.D., L.A.C., B.S., A.C.M., D.M.L.-J.), and National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda, MD (C.M.L.).
- ORCID
- Venue
- Circulation
- Published
- 2012-02-28
- Volume
- 125
- Issue
- 8
- Pages
- 996-1004
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3353808
- OpenAlex
- W2114377026
- Cited by
- 371
- References
- 46
- Citations by year
- 2026: 18 · 2025: 18 · 2024: 24 · 2023: 30 · 2022: 28 · 2021: 46 · 2020: 28 · 2019: 23 · 2018: 30 · 2017: 22 · 2016: 26 · 2015: 22 · 2014: 18 · 2013: 23 · 2012: 14
- FWCI
- 15.85
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc95095-66-0-1, n01hc48047-55-0-1, n01hc48049-61-0-1)
- National Heart, Lung, and Blood Institute (N01 HC 95095, N01-HC-048049, N01 HC095095, N01 HC048047, N01-HC-480-47)
- National Center for Research Resources (UL1RR025741)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- healthy lifestyle, early adulthood, middle age (human life stage), body mass index, alcohol consumption, healthy eating, physical activity, never smoking, untreated hypertension, CARDIA study, sex differences, racial differences
- MeSH terms
- Adult, Age Factors, Cardiovascular Diseases, Coronary Artery Disease, Female, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Risk Factors, Cohort Studies, Young Adult
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