Low-risk lifestyle, coronary calcium, cardiovascular events, and mortality: Results from MESA

Haitham M. Ahmed, Michael J. Blaha, Khurram Nasir, Steven R. Jones, Juan J. Rivera, Arthur Agatston, Ron Blankstein, Nathan D. Wong, Susan Lakoski, Matthew J. Budoff, Gregory L. Burke, Christopher T. Sibley, Pamela Ouyang, Roger S. Blumenthal

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Unhealthy lifestyle habits are a major contributor to coronary artery disease. The purpose of the present study was to investigate the associations of smoking, weight maintenance, physical activity, and diet with coronary calcium, cardiovascular events, and mortality. US participants who were 44-84 years of age (n = 6,229) were followed in the Multi-Ethnic Study of Atherosclerosis from 2000 to 2010. A lifestyle score ranging from 0 to 4 was created using diet, exercise, body mass index, and smoking status. Coronary calcium was measured at baseline and a mean of 3.1 (standard deviation, 1.3) years later to assess calcium progression. Participants who experienced coronary events or died were followed for a median of 7.6 (standard deviation, 1.5) years. Participants with lifestyle scores of 1, 2, 3, and 4 were found to have mean adjusted annual calcium progressions that were 3.5 (95% confidence interval (CI): 0.0, 7.0), 4.2 (95% CI: 0.6, 7.9), 6.8 (95% CI: 2.0, 11.5), and 11.1 (95% CI: 2.2, 20.1) points per year slower, respectively, relative to the reference group (P = 0.003). Unadjusted hazard ratios for death by lifestyle score were as follows: for a score of 1, the hazard ratio was 0.79 (95% CI: 0.61, 1.03); for a score of 2, the hazard ratio was 0.61 (95% CI: 0.46, 0.81); for a score of 3, the hazard ratio was 0.49 (95% CI: 0.32, 0.75); and for a score of 4, the hazard ratio was 0.19 (95% CI: 0.05, 0.75) (P < 0.001 by log-rank test). In conclusion, a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance was associated with lower coronary calcium incidence, slower calcium progression, and lower all-cause mortality over 7.6 years.

Original languageEnglish (US)
Pages (from-to)12-21
Number of pages10
JournalAmerican journal of epidemiology
Volume178
Issue number1
DOIs
StatePublished - Jul 1 2013

Keywords

  • coronary artery disease
  • CT and MRI
  • diet
  • epidemiology
  • exercise
  • primary prevention
  • risk factors
  • weight reduction

ASJC Scopus subject areas

  • Epidemiology

Fingerprint Dive into the research topics of 'Low-risk lifestyle, coronary calcium, cardiovascular events, and mortality: Results from MESA'. Together they form a unique fingerprint.

  • Cite this

    Ahmed, H. M., Blaha, M. J., Nasir, K., Jones, S. R., Rivera, J. J., Agatston, A., Blankstein, R., Wong, N. D., Lakoski, S., Budoff, M. J., Burke, G. L., Sibley, C. T., Ouyang, P., & Blumenthal, R. S. (2013). Low-risk lifestyle, coronary calcium, cardiovascular events, and mortality: Results from MESA. American journal of epidemiology, 178(1), 12-21. https://doi.org/10.1093/aje/kws453