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Healthy Lifestyle Score Including Sleep Duration and Cardiovascular Disease Risk

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? 2022 American Journal of Preventive MedicineIntroduction: Although insufficient or prolonged sleep duration is associated with cardiovascular disease, sleep duration is not included in most lifestyle scores. This study evaluates the relationship between a lifestyle score, including sleep duration and cardiovascular disease risk. Methods: A prospective analysis among 67,250 women in the Nurses’ Health Study and 29,114 men in Health Professionals Follow-up Study (1986–2016) was conducted in 2021. Lifestyle factors were updated every 2–4 years using self-reported questionnaires. The traditional lifestyle score was defined as not smoking, having a normal BMI, being physically active (≥30 minutes/day of moderate physical activity), eating a healthy diet, and drinking alcohol in moderation. Low-risk sleep duration, defined as sleeping ≥6 to <8 hours/day, was included as an additional component in the updated lifestyle score. Cox proportional hazard regression models were used to estimate cardiovascular disease risk. The likelihood-ratio test and C-statistics were used to compare both scores. Results: A total of 11,710 incident cardiovascular disease cases during follow-up were documented. The multivariable-adjusted hazard ratios comparing 6 with 0 low-risk factors in the healthy lifestyle score including sleep duration were 0.17 (95% CI=0.12, 0.23) for cardiovascular disease, 0.14 (95% CI=0.10, 0.21) for coronary heart disease, and 0.20 (95% CI=0.12, 0.33) for stroke. Approximately 66% (95% CI=56%, 75%) of cardiovascular disease, 67% (95% CI=54%, 77%) of coronary heart disease, and 62% (95% CI=42%, 76%) of stroke cases were attributable to poor adherence to a healthy lifestyle including sleep. Adding sleep duration to the score slightly increased the C-statistics from 0.64 (95% CI=0.63, 0.64) to 0.65 (95% CI=0.64, 0.65) (p<0.001). Conclusions: Adopting a healthy lifestyle including sleep recommendations could substantially reduce the risk of cardiovascular disease in U.S. adults.

Guasch-Ferre M.、Li Y.、Bhupathiraju S.N.、Huang T.、Drouin-Chartier J.-P.、Manson J.E.、Sun Q.、Rimm E.B.、Rexrode K.M.、Willett W.C.、Stampfer M.J.、Hu F.B.

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Department of Nutrition Harvard T.H. Chan School of Public Health

Channing Division of Network Medicine Department of Medicine Research Brigham and Women's Hospital

Centre Nutrition Santé et Société (NUTRISS) Institut sur la Nutrition et les Aliments Fonctionnels

2022

American Journal of Preventive Medicine

American Journal of Preventive Medicine

SCI
ISSN:0749-3797
年,卷(期):2022.63(1)
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