Abstract P149: Maintenance of Optimal Health Behaviors Over 25 Years and Cumulative Blood Pressure Burden: Prospective Data From the Coronary Artery Risk Development in Young Adults Study

Abstract

Introduction: Healthy behaviors lower blood pressure (BP) in short-term randomized trials. Hypothesis: Maintaining healthy behaviors for 25 years will be associated with low cumulative BP burden. Methods: In 1985-86, the Coronary Artery Risk Development in Young Adults (CARDIA) study enrolled 5115 adults 18-30 years old. BP and health behaviors were measured at 8 exams over 25 years. Optimal health behaviors were body mass index (BMI) < 25 kg/m 2 , never smoking, moderate / vigorous physical activity ≥ 150 minutes weekly, no / moderate alcohol intake (women / men: 0-7 / 0-14 drinks weekly) and Dietary Approaches to Stop Hypertension (DASH) adherence score ≥ 15. Also, maintaining ≥ 4 optimal behaviors was assessed. Using Proc Traj in SAS, 4630 adults who had ≥ 1 optimal behavior at baseline and attended ≥ 3 exams were grouped by change in mid-BP with age. Odds ratios (OR) were calculated for each higher level of BP burden associated with maintaining versus not maintaining optimal behaviors at all exams. Results: Those who did versus did not maintain optimal BMI were less likely to have moderate-stable, elevated-stable or moderate / elevated-increasing versus low-stable BP burden ( Figure, Panel A ). There was a non-statistically significant lower OR for the highest versus low-stable BP burden in adults who maintained optimal smoking and alcohol intake ( Figure, Panels B-C ). Optimal physical activity and DASH diet were not associated with mid-BP burden ( Figure, Panels D-E ). The OR (95% CI) for moderate / elevated-increasing versus low-stable BP burden in those maintaining ≥ 4 optimal behaviors was 0.73 (0.39 - 1.38). Conclusion: Maintaining optimal BMI into middle age preserves low BP burden.