Wednesday, Mar 23, 2011, 3:30 PM - 5:00 PM
Healthy Lifestyle Change Predicts Odds of Subclinical Atherosclerosis at Year 20 in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Atrium Ballroom A
Wednesday, Mar 23, 2011, 4:00 PM - 4:15 PM
+EPI - Psychosocial/Behavioral
Prevention; Subclinical atherosclerosis; Longitudinal studies
, Arlen C. Moller, Laura Colangelo, Juned Siddique, Megan Roehrig, Martha L. Daviglus, Kiang Liu, Northwestern Univ, Chicago, IL
Absence of lifestyle risk factors is associated with low coronary artery disease risk, but only a small percent of individuals (<10%) reach young adulthood without risk factors. Therefore, we investigated whether making changes in healthy lifestyle factors (HLFs) is associated with developing coronary artery calcification (CAC) and carotid intima-media thickening (IMT) over 20 years. Using data from the CARDIA Study (n=4941), we assessed five healthy lifestyle factors at Years 0 and 20: BMI (<25 kg/m
), alcohol intake (women: ≤15 g/day; men: ≤30 g/day), diet (best 40% of cohort by race and sex: high in potassium, calcium, & fiber; low in saturated fatty acids), physical activity (>300 exercise units), not a cigarette smoker (Yes/No). A continuous composite HLF score was calculated at Years 0 and 20 (range: 0-5), as was change in HLF score from Years 0 to 20 (HLFΔ; range: -5 to +5). The mean HLFΔ was -0.24; 27% (1324/4941) of the sample improved; 41% (2012/4941) deteriorated; 33% (1604/4941) stayed the same. Missing values were replaced prior to analyses using multiple imputation; sensitivity analysis using non-imputed data yielded a consistent pattern of findings. Lifestyle improvement was associated with significantly reduced odds of CAC and IMT thickening at Year 20. A 1 unit increase from baseline in HLFs was associated with 15% reduced odds of CAC (p=0.03). Positive lifestyle change was associated with less thickening of the common IMT (CCMAX), bulb IMT (BULBMAX), and internal IMT (ICAMAX) at Year 20, as tabled below. A one unit increase from baseline in HLFs was associated with reduced odds of being in the top 20% of IMT at Year 20. In sum, even after controlling for the effects of demographics and baseline HLF, improvement in HLFs was significantly associated with reduced odds of subclinical atherosclerosis 20 years later.
Table 1: Odds ratios and regression coefficients associated with 1 unit increase from baseline in HLFs
. Analysis controlled for age, gender, race, and baseline HLFs; *IMT endpoints were treated as continuous.
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