{"title":"The relationship between healthy lifestyle score and incident cardiovascular disease: results from Isfahan Cohort Study (ICS).","authors":"Shahnaz Amani Tirani, Parisa Hajihashemi, Motahare Bateni, Noushin Mohammadifard, Fahimeh Haghighatdoost, Maryam Boshtam, Jamshid Najafian, Masoumeh Sadeghi, Mansoureh Boshtam, Nizal Sarrafzadegan","doi":"10.1186/s13690-025-01696-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence on the combined impact of healthy lifestyle factors on cardiovascular disease (CVD) risk in the Iranian population is limited. This study aimed to examine the association between a healthy lifestyle score (HLS) and the incidence of CVD.</p><p><strong>Methods: </strong>This prospective cohort study, including 5419 adults aged over 35 years, was performed in the framework of the Isfahan Cohort Study (ICS) which is an ongoing study. The HLS (ranging from 0 (unhealthy) to 4 (most healthy)) was derived from four modifiable risk factors: never smoking, diet quality, physical activity, and body mass index (BMI). Investigated cardiovascular outcomes included myocardial infarction (MI), stroke, unstable angina (UA), and CVD mortality. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and assigned 95% confidence intervals (CI).</p><p><strong>Results: </strong>Over a median follow-up of 11.25 years, 785 CVD events occurred, including 159 MI, 164 stroke, 369 UA, and 172 CVD deaths. In the fully-adjusted model, participants with the highest HLS (3-4) had a significantly lower risk of stroke (HR: 0.51; 95% CI: 0.31-0.83; P trend = 0.019) and a tendency towards lower risk of CVD (HR: 0.78; 95% CI: 0.61-0.98; P trend = 0.053) compared to individuals with the lowest HLS (0-1). No significant association was found for MI, UA, or CVD mortality. Age- and sex-specific patterns were also noted for stroke and overall CVD.</p><p><strong>Conclusion: </strong>Our results suggest that a healthier lifestyle was linked to a reduced risk of stroke and showed a trend toward lower CVD risk among Iranian adults. These associations may vary by age and sex.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"211"},"PeriodicalIF":3.2000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359934/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13690-025-01696-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Evidence on the combined impact of healthy lifestyle factors on cardiovascular disease (CVD) risk in the Iranian population is limited. This study aimed to examine the association between a healthy lifestyle score (HLS) and the incidence of CVD.
Methods: This prospective cohort study, including 5419 adults aged over 35 years, was performed in the framework of the Isfahan Cohort Study (ICS) which is an ongoing study. The HLS (ranging from 0 (unhealthy) to 4 (most healthy)) was derived from four modifiable risk factors: never smoking, diet quality, physical activity, and body mass index (BMI). Investigated cardiovascular outcomes included myocardial infarction (MI), stroke, unstable angina (UA), and CVD mortality. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and assigned 95% confidence intervals (CI).
Results: Over a median follow-up of 11.25 years, 785 CVD events occurred, including 159 MI, 164 stroke, 369 UA, and 172 CVD deaths. In the fully-adjusted model, participants with the highest HLS (3-4) had a significantly lower risk of stroke (HR: 0.51; 95% CI: 0.31-0.83; P trend = 0.019) and a tendency towards lower risk of CVD (HR: 0.78; 95% CI: 0.61-0.98; P trend = 0.053) compared to individuals with the lowest HLS (0-1). No significant association was found for MI, UA, or CVD mortality. Age- and sex-specific patterns were also noted for stroke and overall CVD.
Conclusion: Our results suggest that a healthier lifestyle was linked to a reduced risk of stroke and showed a trend toward lower CVD risk among Iranian adults. These associations may vary by age and sex.
期刊介绍：
rchives of Public Health is a broad scope public health journal, dedicated to publishing all sound science in the field of public health. The journal aims to better the understanding of the health of populations. The journal contributes to public health knowledge, enhances the interaction between research, policy and practice and stimulates public health monitoring and indicator development. The journal considers submissions on health outcomes and their determinants, with clear statements about the public health and policy implications. Archives of Public Health welcomes methodological papers (e.g., on study design and bias), papers on health services research, health economics, community interventions, and epidemiological studies dealing with international comparisons, the determinants of inequality in health, and the environmental, behavioural, social, demographic and occupational correlates of health and diseases.
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