Healthy lifestyle index and risk of cardiovascular disease among postmenopausal women with normal body mass index

A lifestyle comprising a healthy diet, light alcohol consumption, no smoking, and moderate or intense physical activity has been associated with reduced risk of cardiovascular disease (CVD). Researchers examined the association of a healthy lifestyle index, derived from scores for each of these components plus waist circumference, with the risk of incident CVD and CVD subtypes in postmenopausal women with normal body mass index (18.5–<25.0 kg/m2). The study was based on 40,118 participants in the Women’s Health Initiative, aged 50 to 79 years at enrolment, with a normal body mass index and no history of CVD. The healthy lifestyle index score was categorized into quintiles. Multivariable adjusted hazard ratios (HR) and 95% CIs for the association of healthy lifestyle index with risk of CVD and CVD subtypes were estimated. A total of 3,821 cases of incident CVD were ascertained during a median follow‐up of 20.1 years. Compared with the lowest quintile (unhealthiest lifestyle), higher healthy lifestyle index quintiles showed inverse associations with the risk of CVD (HRquintile−2=0.74 [95% CI, 0.67–0.81]; HRquintile−3=0.66 [95% CI, 0.60–0.72]; HRquintile−4=0.57 [95% CI, 0.51–0.63]; and HRquintile−5=0.48 [95% CI, 0.43–0.54). Healthy lifestyle index was also inversely associated with risks of stroke, coronary heart disease, myocardial infarction, angina, and coronary revascularization. Subgroup analyses, stratified by age (≤63 years vs >63 years), body mass index (</≥ 22.0 kg/m2), and general health status (absence/presence of hypertension, diabetes, or lipid‐lowering drug use) also showed inverse associations between healthy lifestyle index and risk of CVD.
Among postmenopausal women with a normal body mass index, adherence to a healthy lifestyle, which included light alcohol consumption, was associated with a reduced risk of clinical CVD and CVD subtypes, underscoring the cardiovascular benefits of maintaining a healthy lifestyle, even for women with a healthy weight.
Source: Peila R, Xue X, Qi Q, Dannenberg AJ, Allison MA, Johnson KC, LaMonte MJ, Wild RA, Haring B, Pan K, Tindle HA, Foraker R, Saquib N, Barac A, Rohan TE. Healthy Lifestyle Index and Risk of Cardiovascular Disease Among Postmenopausal Women With Normal Body Mass Index. J Am Heart Assoc. 2023 Jun 20;12(12):e029111.