Abstract P457: Healthful Lifestyle Factors and Incidence of Early Onset Cardiovascular Disease in the Million Veteran Program

Abstract

Background and Objective: While previous studies have reported benefits of healthful and modifiable lifestyle factors on the incidence of cardiovascular disease (CVD) among adults, it is unclear whether adhering to healthful lifestyle factors is associated with a lower risk of CVD among young adults. Thus, the purpose of this study is to examine the association of low-risk lifestyle factors including normal weight, regular exercise, not smoking, adequate sleep, and a healthy diet with risk of early onset CVD in the Veterans Affairs (VA) Million Veteran Program (MVP). Methods: The study cohort included 49,603 MVP participants with self-reported and electronic health records information on the five low-risk lifestyle factors. Assigning values to each lifestyle factor, we created a score that ranges from 2 to 15 with higher scores indicating a healthier lifestyle. The association between low-risk lifestyle factors and fatal and non-fatal CVD was assessed using Cox proportional hazard model adjusted for age, sex, race, education, income, marital status, alcohol use, total energy intake, diabetes, hypertension, and hypercholesterolemia. Results: The mean age was 47 years and 37 % were women. After a follow-up period of 3.1 years, we documented 655 early onset CVD events with an overall crude annual incident rate of 3.5‰ among women and 3.9‰ among men. In Cox proportional hazard model adjusted for confounders, a higher low-risk lifestyle score was associated with a lower risk of early onset CVD [hazard ratio (HR) = 0.43, 95% confidence interval (CI): 0.33-0.56, comparing extreme score, Figure]. Conclusion: Our data show an inverse and graded association of healthful lifestyle factors with risk of early onset CVD among young veterans, suggesting that adherence to low-risk lifestyle factors including not smoking, sufficient sleep, normal weight, and regular exercise may help prevent early onset CVD.