[Association between lifestyle and life expectancy in adults in Henan Province]

Objective: To analyze the association between lifestyle and life expectancy in adults in Henan Province. Methods: Data from the Programme of Screening and Intervention Subjects with High-risk Cardiovascular Disease in Henan Province from 2015 to 2022 were used. The endpoint outcomes were obtained through the National Mortality Surveillance System of the China CDC. The Royston-Parmar flexible parametric survival model is implemented using age at death as the time scale. The area under the curve method was utilized to estimate the association between lifestyle factors and life expectancy across gender, with adjustment for confounding variables. Results: The mean follow-up period of this study was 4.8 years, and 2 685 death events were recorded. The Royston-Parmar flexible parametric survival analysis model showed that healthy lifestyle factors were strongly associated with life expectancy. Among men, non-smokers had a 1.1 (95%CI: 0.5-1.8) years longer life expectancy than smokers. Similarly, non-drinkers or light drinkers lived 2.2 (95%CI: 1.4-3.0) years longer on average than excessive drinkers. Additionally, those with sufficient physical activity had a 1.5 (95%CI: 0.7-2.2) years increase in life expectancy compared with those with insufficient physical activity. In women, sufficient exercise was associated with a 1.5 (95%CI: 0.8-2.1) years longer life expectancy than insufficient exercise. Compared with individuals with 0-1 healthy lifestyles, men with 3-4 healthy lifestyles gained 3.9 (95%CI: 2.6-5.1) years of life expectancy, while those with 2 healthy lifestyles gained 2.0 (95%CI: 1.2-2.8) years. The corresponding gains were 2.1 (95%CI: 1.0-3.3) years and 1.2 (95%CI: 0.5-1.9) years among women. Conclusion: Healthy lifestyle adherence is associated with longer life expectancy among adults resident in Henan Province, following more healthy behaviors leads to greater gains in life expectancy.