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Journal article

Lifestyle, cardiometabolic disease and multimorbidity in a prospective Chinese study

Abstract:

Aims: The potential difference in the impacts of lifestyle factors (LFs) on progression from healthy to first cardiometabolic disease (FCMD), subsequently to cardiometabolic multimorbidity (CMM), and further to death is unclear.

Methods and Results: We used data from the China Kadoorie Biobank of 461 047 adults aged 30-79 free of heart disease, stroke, and diabetes at baseline. CMM was defined as the coexistence of two or three CMDs, including ischemic heart disease (IHD), stroke, and type 2 diabetes (T2D). We used multi-state model to analyze the impacts of high-risk LFs (current smoking or quitting because of illness, current excessive alcohol drinking or quitting, poor diet, physical inactivity, and unhealthy body shape) on the progression of CMD. During a median follow-up of 11.2 years, 87 687 participants developed at least one CMD, 14 164 developed CMM, and 17 541 died afterwards. Five high-risk LFs played crucial but different roles in all transitions from healthy to FCMD, to CMM, and then to death. The hazard ratios (95% confidence intervals) per 1-factor increase were 1.20 (1.19, 1.21) and 1.14 (1.11, 1.16) for transitions from healthy to FCMD, and from FCMD to CMM, and 1.21 (1.19, 1.23), 1.12 (1.10, 1.15), and 1.10 (1.06, 1.15) for mortality risk from healthy, FCMD, and CMM, respectively. When we further divided FCMDs into IHD, ischemic stroke, haemorrhage stroke, and T2D, we found that LFs played different roles in disease-specific transitions even within the same transition stage.

Conclusion: Assuming causality exists, our findings emphasize the significance of integrating comprehensive lifestyle interventions into both health management and CMD management.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/eurheartj/ehab413

Authors

More by this author
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Clinical Trial Service Unit
Role:
Author
More by this author
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Clinical Trial Service Unit
Role:
Author
More by this author
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Clinical Trial Service Unit
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Clinical Trial Service Unit
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Clinical Trial Service Unit
Role:
Author

Contributors

Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Clinical Trial Service Unit
Role:
Contributor


Publisher:
Oxford University Press
Journal:
European Heart Journal More from this journal
Volume:
42
Issue:
34
Pages:
3374–3384
Publication date:
2021-08-01
Acceptance date:
2021-05-25
DOI:
EISSN:
1522-9645
ISSN:
0195-668X


Language:
English
Keywords:
Pubs id:
1183176
Local pid:
pubs:1183176
Deposit date:
2021-06-23
ARK identifier:

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