Journal article
Lifestyle, cardiometabolic disease and multimorbidity in a prospective Chinese study
- Abstract:
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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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(Preview, Version of record, pdf, 4.8MB, Terms of use)
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- Publisher copy:
- 10.1093/eurheartj/ehab413
Authors
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:
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1522-9645
- ISSN:
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0195-668X
- Language:
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English
- Keywords:
- Pubs id:
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1183176
- Local pid:
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pubs:1183176
- Deposit date:
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2021-06-23
- ARK identifier:
Terms of use
- Copyright holder:
- Han et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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