April 28, 2014
TAKE-HOME MESSAGE
- Healthy young adults were followed for the development of subclinical atherosclerosis over 20 years; five healthy lifestyle factors were assessed in these individuals. After 20 years, having more healthy lifestyle factors was associated with decreased coronary artery calcification and lower carotid intima media thickness.
- Healthy lifestyle changes, which we often recommend, are associated with less subclinical atherosclerosis as assessed by imaging after 20 years.
– Samer Ajam, MD
ABSTRACT
BACKGROUND
The benefits of healthy habits are well-established, but it is unclear whether making health behavior changes as an adult can still alter coronary artery disease risk.
METHODS AND RESULTS
The Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study (n = 3538) assessed 5 healthy lifestyle factors (HLFs) among young adults between ages 18-30 (Year 0 baseline) and 20 years later (Year 20): not overweight/obese, low alcohol intake, healthy diet, physically active, nonsmoker. We tested whether change from Year 0 to 20 in a continuous composite HLF score (HLF change; range: -5 to +5) is associated with subclinical atherosclerosis [coronary artery calcification (CAC) and carotid intima-media thickness (IMT)] at Year 20, after adjustment for demographics, medications, and baseline HLFs. By Year 20, 25∙3% of the sample improved (HLF change > +1); 40∙4% deteriorated (had fewer HLFs); 34∙4% stayed the same; 19∙2% had CAC (>0). Each increase in HLFs was associated with reduced odds of detectable CAC (OR = .85, 95% CI: .74 – .98) and lower IMT (carotid bulb β = -.024, p = 0.001), and each decrease in HLFs was predictive to a similar degree of greater odds of CAC (OR = 1.17, 95% CI: 1.02 – 1.33) and greater IMT (β = +.020, p < 0.01).
CONCLUSIONS
Healthy lifestyle changes during young adulthood are associated with decreased, and unhealthy lifestyle changes with increased risk for subclinical atherosclerosis in middle age.
Circulation
Healthy Lifestyle Change and Subclinical Atherosclerosis in Young Adults: Coronary Artery Risk Development in Young Adults (CARDIA) Study
Circulation 2014 Apr 28;[EPub Ahead of Print], B Spring, AC Moller, LA Colangel, J Siddique, M Roehrig, ML Daviglus, JF Polak, JP Reis, S Sidney, K Liu