Healthy lifestyle behaviours and cardiovascular mortality among Japanese men and women: the Japan collaborative cohort study

Eguchi, Eri; Iso, Hiroyasu; Tanabe, Naohito; Wada, Yasuhiko; Yatsuya, Hiroshi; Kikuchi, Shogo; Inaba, Yutaka; Tamakoshi, Akiko

doi:10.1093/eurheartj/ehr429

Cited by 90 publications

(106 citation statements)

References 30 publications

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“…Downloaded from http://ahajournals.org by on March 28, 2019 Stroke March 2017 mortality. [19][20][21] However, variations in the timing of the assessment of lifestyle, length of follow-up, and choice of outcome measure (all-cause or stroke-specific mortality) between the studies make direct comparisons difficult. To the best of our knowledge, our study is the first study to examine the association between lifestyle factors assessed at the time of admission (combined and individual factors) and a broader range of early outcomes.…”

Section: Discussionmentioning

confidence: 99%

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Ingeman

Andersen

Thomsen

et al. 2017

Stroke

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2 ), smoking habits, and alcohol intake, which were grouped (healthy, moderately healthy, moderately unhealthy, and unhealthy). The associations between lifestyle and outcomes were examined using multivariable regression. Results-A total of 18.3% had a severe stroke, 7.8% pneumonia, 12.5% urinary tract infection, and 9.9% died within 30 days. The association between lifestyle, stroke severity, and mortality, respectively, differed according to sex. However, underweight may be a particular concern being associated with an increased risk of adverse outcomes among both sexes.

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Section: Discussionmentioning

confidence: 99%

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Ingeman

Andersen

Thomsen

et al. 2017

Stroke

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“…5 A healthy lifestyle, based on 3 food groups (fruits, fish, and milk) and 5 other factors (alcohol consumption, physical activity, BMI, smoking, and sleep duration), was associated with a similar reduction in stroke in a cohort of Japanese women and men. 6 We observed no association between a healthy lifestyle (all 5 low-risk lifestyle factors) and risk of hemorrhagic stroke. Because of the relatively small number of hemorrhagic stroke cases (n 5 246), the CIs for the risk estimates were wide and overlapped with those for cerebral infarction.…”

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confidence: 52%

“…[3][4][5][6] The objective of the present study was to examine the combined effect of multiple low-risk lifestyle factors (healthy diet, 7 moderate alcohol consumption, never smoking, physically active, and healthy body weight) on incidence of total stroke and stroke types in a population-based prospective cohort of Swedish women.…”

Section: Methodsmentioning

confidence: 99%

Healthy diet and lifestyle and risk of stroke in a prospective cohort of women

Braillon¹,

Larsson²,

Åkesson³

2015

Neurology

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Objective: To investigate the association between a low-risk lifestyle and risk of stroke. Methods:The study population comprised 31,696 women, in the population-based SwedishMammography Cohort who at baseline had completed a questionnaire about diet and lifestyle and were free from cardiovascular disease and cancer. We defined a low-risk lifestyle as a healthy diet (top 50% of a Recommended Food Score), moderate alcohol consumption (5-15 g/d), never smoking, physically active (walking/bicycling $40 min/d and exercise $1 h/wk), and body mass index below 25 kg/m 2 . Stroke cases were identified from the Swedish National Patient Register and the Swedish Cause of Death Register. Stroke is a major cause of disability and mortality. Because the consequences of stroke are usually devastating and irreversible, primary prevention is of great importance. Hypertension is a strong and well-documented risk factor for stroke.1 Diet, alcohol consumption, smoking, physical activity, and adiposity can modify blood pressure and thus the risk of stroke.1,2 Few studies have examined the combined effect of a low-risk lifestyle on the incidence of stroke. [3][4][5][6] The objective of the present study was to examine the combined effect of multiple low-risk lifestyle factors (healthy diet, 7 moderate alcohol consumption, never smoking, physically active, and healthy body weight) on incidence of total stroke and stroke types in a population-based prospective cohort of Swedish women.METHODS Study population. For the present study, we used data from the Swedish Mammography Cohort, which has been described in detail previously. 8 Briefly, in the autumn of 1997, 39,227 women who resided in Uppsala and Västmanland counties, central Sweden, and were born between 1914 and 1948 completed a 350-item questionnaire concerning diet and lifestyle.Standard protocol approvals, registrations, and patient consents. The Regional Ethical Review Board at Karolinska Institutet in Stockholm, Sweden, approved this study. Return of the completed questionnaire was considered to imply informed consent.Assessment of lifestyle factors. At baseline in 1997, all participants of the Swedish Mammography Cohort completed a selfadministered questionnaire that solicited information on education, body weight, height, smoking, physical activity, use of aspirin, history of hypertension and diabetes, family history of myocardial infarction before the age of 60 years, alcohol consumption, and diet. Participants indicated how many minutes or hours per day they had walked/bicycled (almost never, ,20 min/d, 20-40 min/d,

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“…2,3 The combined effect of multiple modifiable lifestyle factors on stroke risk have shown impressive 44% to 79% reduced risk. [4][5][6][7][8][9] However, little is known about the impact of a healthy lifestyle on stroke risk in individuals at higher risk of stroke due to other cardiovascular diseases or conditions.…”

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confidence: 99%

Primary prevention of stroke by a healthy lifestyle in a high-risk group

2015

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Objective: To examine the impact of a healthy lifestyle on stroke risk in men at higher risk of stroke because of other cardiovascular diseases or conditions. Methods: Our study population comprised 11,450 men in the Cohort of Swedish Men who had a history of hypertension, high cholesterol levels, diabetes, heart failure, or atrial fibrillation. Participants had completed a questionnaire about diet and lifestyle and were free from stroke and ischemic heart disease at baseline (January 1, 1998). We defined a healthy lifestyle as a lowrisk diet ($5 servings/d of fruits and vegetables and ,30 g/d of processed meat), not smoking, $150 min/wk of physical activity, body mass index of 18.5 to 25 kg/m 2 , and low to moderate alcohol consumption (.0 to #30 g/d). Ascertainment of stroke cases was accomplished through linkage with the National Inpatient Register and the Swedish Cause of Death Register.Results: During a mean follow-up of 9.8 years, we ascertained 1,062 incident stroke cases. The risk of total stroke and stroke types decreased with increasing number of healthy lifestyle factors. The multivariable relative risk of total stroke for men who achieved all 5 healthy lifestyle factors compared with men who achieved 0 or 1 factor was 0.28 (95% confidence interval 0.14-0.55). The corresponding relative risks (95% confidence interval) were 0.31 (0.15-0.66) for ischemic stroke and 0.32 (0.04-2.51) for hemorrhagic stroke. Primary prevention of stroke is of outmost importance because the consequences of the disease are often devastating and irreversible, and stroke is the second leading cause of death in individuals older than 60 years.1 Smoking, being overweight, physical inactivity, alcohol consumption, and poor diet are well-established lifestyle-related risk factors for stroke.2,3 The combined effect of multiple modifiable lifestyle factors on stroke risk have shown impressive 44% to 79% reduced risk.4-9 However, little is known about the impact of a healthy lifestyle on stroke risk in individuals at higher risk of stroke due to other cardiovascular diseases or conditions.We investigated the joint effect of 5 indicators of a healthy lifestyle (no smoking, healthy body mass index [BMI], physical activity, moderate alcohol consumption, and diet) on total and type-specific stroke incidence in men at higher risk of stroke due to a history of hypertension, high cholesterol levels, diabetes, heart failure, or atrial fibrillation.METHODS Study population. We used data from the Cohort of Swedish Men, which was established in the autumn of 1997 when all men who were born between 1918 and 1952 and resided in Västmanland and Örebro counties in central Sweden received a 350-item questionnaire. A total of 48,850 men (49% response rate) returned a completed questionnaire. Participants are representative of the Swedish male population in age distribution, educational level, and prevalence of overweight. 10Standard protocol approvals, registrations, and patient consents. The Regional Ethical Review Board at Karolinska Instit...

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Healthy lifestyle behaviours and cardiovascular mortality among Japanese men and women: the Japan collaborative cohort study

Abstract: Mortality from stroke, CHD, and CVD in the highest healthy lifestyle score category was one-third in men and one-fourth in women of those in the lowest scores, suggesting that a large fraction of CVD could be prevented through lifestyle modification.

Cited by 90 publications

References 30 publications

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Healthy diet and lifestyle and risk of stroke in a prospective cohort of women

Primary prevention of stroke by a healthy lifestyle in a high-risk group

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