Impact of a comprehensive healthy lifestyle score on a broad spectrum of cardiometabolic and related diseases and its incremental value for risk prediction based on the UK biobank database

Journal of Cardiothoracic Surgery

卷:21

Research

Xinyue Chen^1,2,3  Sen Han⁴  Yating Chen⁵  Sheng Yuan^1,2,3  Jining He^1,2,3  Zixiang Ye^1,2,3  Yanjun Song^1,2,3  Kefei Dou^1,2,3,6 

[1] National Clinical Research Center for Cardiovascular Diseases, 167A Beilishi Road, Xi Cheng District, 100037, Beijing, China

[2] Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology II, Peking University Cancer Hospital and Institute, Beijing, China

[3] Beijing Anzhen Hospital, Capital Medical University, Beijing, China

[4] Coronary Heart Disease Center, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, 100037, BeijingBeijing, China

[5] State Key Laboratory of Cardiovascular Disease, 167A Beilishi Road, Xi Cheng District, 100037, Beijing, China

[6] Cardiometabolic Medicine Center, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, 100037, BeijingBeijing, China

关键词: Cardiometabolic diseases;    Healthy lifestyle;    Primary prevention;    Risk stratification;   

DOI  :  10.1186/s13019-026-04485-z

 received in 2026-03-05, accepted in 2026-06-15,  发布年份 2026

来源: Springer

【 摘 要 】

BackgroundCardiometabolic and related diseases (CMDs) represent a major global disease burden. While traditional risk factors are well-established, the role of lifestyle factors in primary prevention has not been sufficiently studied.MethodsThis study analyzed data from 148,155 participants in the UK Biobank without baseline CMDs. Cox proportional hazards models were used to assess the impact of healthy lifestyle factors (non-current smoking, non-excessive drinking, regular physical activity, healthy diet, and healthy sleep) on 11 types of CMDs (coronary heart disease, type 2 diabetes, atrial fibrillation, hypertension, stroke, heart failure, Alzheimer’s disease, non-alcoholic fatty liver disease, valvular heart disease, cardiomyopathy, and pulmonary hypertension). Participants were categorized into four groups based on weighted lifestyle scores. Improvements in predictive models after incorporating lifestyle factors were evaluated.ResultsMost individual healthy lifestyle factors were associated with a lower risk of CMDs, while regular physical activity was not independently associated with composite CMD risk in the fully adjusted model; healthy sleep contributed the largest weight to the composite lifestyle score (β = 0.342). Adhering to a healthier lifestyle demonstrated a significant and dose–response association with a reduced risk of composite CMDs. In the fully adjusted model, compared to the “very unhealthy” group, the “very healthy” group exhibited a significantly lower risk of developing CMDs (HR: 0.70, 95% CI: 0.67–0.74). Similar inverse associations were observed across several individual CMDs, with the strongest association observed for pulmonary hypertension (HR: 0.34, 95% CI: 0.24–0.50). Incorporating the lifestyle score into traditional risk models was associated with modest improvement in predictive performance. The findings were generally consistent across subgroups and sensitivity analyses.ConclusionsThese findings suggest that adherence to a comprehensive healthy lifestyle, including adequate sleep, is associated with reduced risk of various CMDs and may improve risk stratification. The particularly strong association observed for pulmonary hypertension also supports further investigation of lifestyle patterns across a broader range of cardiometabolic and related conditions.Trial registrationNot applicable.

【 授权许可】

CC BY-NC-ND   
© The Author(s) 2026

【 图 表 】

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Figure 3. Generation of the cell line.