January 28, 2024
2 min read
- A healthy lifestyle combined with statin use can improve life expectancy.
- High-risk adults taking statins with a “very healthy” lifestyle had the most years of life gained.
The combination of statin use and healthy lifestyle was linked to a 30% lower risk for all-cause death and 44% reduced risk for CV death in people at high CV risk vs. those not taking statins with an unhealthy lifestyle, data show.
“Previous studies have investigated the combined effects of preventive medication and multiple healthy lifestyles on health outcomes, but these studies did not target to candidates for primary prevention of CVD or were limited by outdated lifestyle data,” Jiapeng Lu, PhD, of the National Clinical Research Center of Cardiovascular Diseases, Beijing Fuwai Hospital, China, and colleagues wrote. “Our study extends the existing research in several ways and has some potential clinical implications.”
Lu and colleagues analyzed data from 265,209 adults aged 35 to 75 years without a history of CVD from 2015 to 2021, all recruited by ChinaHEART, a public health project funded by the Chinese government to screen and manage people at high CVD risk. Data on lifestyle behaviors, such as smoking, alcohol drinking, physical activity and diet, were collected through questionnaire interviews. Researchers stratified participants based on lifestyle factors as “very healthy,” “healthy” or “unhealthy.” Participants also self-reported their statin use from the previous 2 weeks. The researchers examined the associations of statin use and healthy lifestyle with risk for all-cause mortality, with participants not taking statin and following an unhealthy lifestyle as the reference group. Participants deemed high risk for CVD were included in the joint association analyses of statin use with lifestyle; those with low or moderate CV risk were included for the comparison of life expectancy.
The findings were published in the American Journal of Preventive Cardiology.
Within the cohort, 16.2% were at high CVD risk, with the rest at low or moderate CVD risk. Among those at high risk, 5.7% were taking a statin; 24.7% had an unhealthy lifestyle, 47.4% had a healthy lifestyle and 27.9% had a very healthy lifestyle.
During a median 3.6 years of follow-up, 6,979 participants died, including 3,236 from CV-related causes.
Researchers found that adults who reported taking statins as prescribed with a very healthy lifestyle had the lowest risk for all-cause mortality (HR = 0.7; 95% CI, 0.57-0.87) and CV mortality (HR = 0.56; 95% CI, 0.4-0.79) compared with statin nonusers with an unhealthy lifestyle. Those taking a statin but with an unhealthy lifestyle saw no significant reduction in risk for all-cause mortality or CV mortality. Results persisted in analyses stratified by sex.
High-risk participants taking statins and with a very healthy lifestyle had the highest years of life gained, with a median of 5.9 years at age 35 years (95% CI, 4.14-7.67; P < .001) compared with nonstatin users at high risk with an unhealthy lifestyle. Additionally, those at high risk who took statins and had a very healthy lifestyle had a life expectancy comparable to those with a very healthy lifestyle without high risk.
“The combination of preventive medication use and adhering to multiple healthy lifestyles was significantly associated with a lower risk of all-cause and CVD mortality, as well as having remarkable benefits in life expectancy. These findings highlight the importance of the combination of preventive medication use and adherence to healthy lifestyles to reduce mortality risk and increase life expectancy for people with high CVD risk.”