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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 is effective in reducing the impact of CVD”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [3]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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“Reassuringly, there is evidence that those who can maintain good metrics as young adults are more likely to retain such profiles in middle age(Liu et al. 2012).”
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“A recent report of 3154 young adults followed for 20 years found that following a healthy lifestyle during early adulthood was associated with a low cardiovascular risk profile in middle age [25].”
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“…you rate your quality of life?” on a scale from 1 = very poor to 5 = very good and “How satisfied are you with your health?” on a scale from 1 = very dissatisfied to 5 = very satisfied (Group WHOQOL, 1993; Skevington et al., 2004; Trompenaars et al., 2005; Lu et al., 2011; Hsiao et al., 2014).”
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“The Alternative Healthy Eating Index-2010 (AHEI-2010), a validated food-based dietary scoring system, was used to assess diet quality based on usual dietary intake (Chiuve et al., 2012; Liu et al., 2012).”
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“Elimination of modifiable risk factors including unhealthy lifestyle allows for prevention of 80% of CVD cases [3], and individuals with desirable lifestyle factors (not smoking, physically active, healthy diet, BMI < 25) are expected to have a 67–72% lower risk of developing heart failure [4], However, actual impleme…”
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“aged 18–30 y, who followed a healthy lifestyle had a 5% reduced cardiovascular disease risk in the subsequent 20 y (2).”
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“lifestyle behaviours that track into later adulthood and increase the risk of chronic disease across the life course(1,2).”
Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment
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“Only the measures of saturated fat, potassium, calcium and fiber-dietary variables related to cardiovascular health (Liu et al., 2012), the AHEI-2010 score and caffeine were adjusted by this larger set of covariates.”
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Background
Metadata
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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