Joanne Foody, MD

In the CARDIA cohort, young adults who acquired or dropped healthy lifestyle factors had concordant increases or decreases in markers of atherosclerosis.

Can making health behavior changes as an adult improve coronary artery disease risk? Investigators for the National Heart, Lung, and Blood Institute–sponsored, prospective CARDIA cohort study assessed five healthy lifestyle factors (HLFs) (not being overweight or obese, having a low alcohol intake, eating a healthy diet, being physically active, and not smoking) among some 3500 young adults between ages 18 and 30. HLFs were assessed again 20 years later to determine whether the change from year 0 to 20 as a continuous composite HLF score (range, −5 to +5) was associated with coronary calcification (CAC) and carotid intima–media thickness (IMT) at year 20, after adjustment for demographics, medications, and baseline HLFs.

Over the 20-year period, 25% of the sample improved (HLF change, ≥1), while 40% deteriorated (had fewer HLFs), and 34% stayed the same. Coronary artery calcium was detectable in 19% of the group as a whole. Each incremental increase in HLFs was associated with significantly reduced odds of detectable CAC (odds ratio, 0.85) and lower IMT (carotid bulb, β=−0.024), whereas each decrease was associated with similarly greater odds of CAC (OR, 1.17) and greater IMT (β=+0.020).

Citation(s):

Spring B et al. Healthy lifestyle change and subclinical atherosclerosis in young adults: Coronary Artery Risk Development in Young Adults (CARDIA) study. Circulation 2014 Apr 28; [e-pub ahead of print].