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Association between inflammatory score, healthy lifestyle, and cardiovascular disease: a national cohort study
Han-Qing Zhao1,2, Jia-Le Lv3,4, Yuan-Zhi Gao2
1Hunan Provincial Center for Disease Control and Prevention, Changsha, China.
Insights
A high inflammation score increases cardiovascular disease (CVD) risk in older adults. However, a healthy lifestyle can negate this increased risk, suggesting a modifiable factor in CVD prevention.
Area of Science:
- Cardiovascular Health
- Inflammation Biomarkers
- Preventive Medicine
Background:
- The inflammation score, a composite index, is used to assess inflammatory status.
- The precise relationship between inflammation score and cardiovascular disease (CVD) risk remains unclear.
- Investigating the interplay between inflammation, lifestyle, and CVD is crucial for public health.
Purpose of the Study:
- To explore the association between inflammation score and the incidence of CVD.
- To evaluate whether adherence to a healthy lifestyle can mitigate the CVD risk associated with a high inflammation score.
- To analyze the interaction between inflammation score and healthy lifestyle adherence in relation to CVD risk.
Main Methods:
- Analysis of 6,164 participants (aged ≥45 years) from the China Longitudinal Study of Health and Retirement (CHARLS) cohort (2011-2018).
- Inflammation score calculated using C-reactive protein and white blood cell count.
- Healthy lifestyle score based on smoking, alcohol consumption, BMI, and sleep duration.
- Cox proportional hazard models used to determine hazard ratios (HRs) and 95% confidence intervals (CIs).
Main Results:
- The highest inflammation score tertile was associated with a 25% increased CVD risk (HR=1.25, 95% CI=1.04-1.49).
- A healthy lifestyle was inversely associated with CVD risk (HR=0.74, 95% CI=0.60-0.93).
- A healthy lifestyle eliminated the significant association between high inflammation score and CVD risk (HR=1.00, 95% CI=0.76-1.34), with a significant interaction detected (p<0.05).
Conclusions:
- Elevated inflammation score is linked to increased CVD incidence in middle-aged and older adults.
- Adherence to a healthy lifestyle can attenuate the adverse effects of inflammation on CVD risk.
- Lifestyle modification represents a potential strategy to mitigate inflammation-driven CVD risk.
Background:
The inflammation score is currently regarded as a reliable composite index for comprehensive assessment of inflammatory status. However, the relationship between inflammation score and cardiovascular disease (CVD) is unclear. Thus, we aimed to explore the association of inflammatory score with CVD, as well as to evaluate whether adhering to a healthy lifestyle could alleviate this association.
Methods:
We analyzed 6,164 participants aged ≥45 years who entered a prospective cohort study of the China Longitudinal Study of Health and Retirement (CHARLS) between 2011 and 2012 and were followed up for CVD incidence untill 2018. The inflammatory score was measured by summing of the Z-scores for C-reactive protein and white blood cell count at baseline. The healthy lifestyle score was calculated by four factors, smoking status, alcohol consumption, body mass index, and sleep duration. Cox proportional hazard models were utilized to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of CVD.
Results:
During the 7-year follow-up period, there were 761 incident cases of CVD. Compared with the lowest tertiles, the highest inflammatory score was associated with an elevated risk of CVD (HR = 1.25, 95% CI = 1.04-1.49). Compared to the unhealthy lifestyle, participants adhered to a healthy lifestyle was inversely associated with CVD risk (HR = 0.74, 95% CI = 0.60-0.93). Of note, when participants adhered to a healthy lifestyle, the higher inflammatory score was no longer significantly correlated with CVD risk (HR = 1.00, 95% CI = 0.76-1.34). Additionally, a multiplicative interaction was detected between inflammatory score and healthy lifestyle score for CVD risk (p interaction <0.05).
Conclusion:
The inflammation score was associated with higher risk of CVD incidence, but adherence to a healthy lifestyle may mitigate the adverse association of inflammation score and CVD among the middle-aged and older participants.
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