Ewha Med J.  2024 Oct;47(4):e60. 10.12771/emj.2024.e60.

Reduced cardiovascular events through dynamic lifestyle modification in individuals with prediabetes or prehypertension in Korea: a nationwide cohort study

• Kim Y
• Song S
• Moon CM
• Lee HA
• Park J

• KMID: 2561415
• DOI: http://doi.org/10.12771/emj.2024.e60

Abstract

Objectives
There is limited knowledge regarding the impact of lifestyle changes on cardiovascular events and mortality among individuals with prehypertension or prediabetes.
Methods
This was a serial retrospective cohort study utilizing data from the Korean National Health Insurance Service Health Screening Cohort. The primary outcome considered in the study was major adverse cardiovascular events (MACE).
Results
A higher risk of MACE was found in men with prehypertension whose unhealthy lifestyle deteriorated (hazard ratio [HR], 1.13; 95% CI, 1.04–1.23; P=0.004), those who gained weight (HR, 1.15; 95% CI, 1.03–1.28; P=0.010), and those who began smoking (HR, 1.34; 95% CI, 1.17–1.55; P<0.001). Conversely, a reduced risk of MACE was observed in men with prehypertension who improved their unhealthy lifestyle, quit smoking, reduced alcohol consumption, or increased the frequency of physical activity. In men with prediabetes, the risk of MACE was higher in those whose unhealthy lifestyle worsened (HR, 1.23; 95% CI, 1.12–1.35; P<0.001), those who gained weight (HR, 1.19; 95% CI, 1.06–1.33; P=0.003), those who started smoking (HR, 1.41; 95% CI, 1.22–1.64; P<0.001), and those who decreased their physical activity frequency (HR, 1.21; 95% CI, 1.09–1.35; P<0.001).
Conclusion
Preventive lifestyle changes reduce cardiovascular events and mortality, particularly in men at risk of developing hypertension or type 2 diabetes.

Keyword

National health programs; Prediabetic state; Prehypertension; Lifestyle; Republic of Korea

Figure

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  Fig. 1. Flow diagram of selection of the study population from the National Health Insurance Service database. (A) Prehypertension subgroup; (B) prediabetes subgroup; (C) overall schema of the study. NHIS, National Health Insurance Service; HF, heart failure; CVD, cardiovascular disease; CVA, cerebrovascular accident; HTN, hypertension; DM, diabetes mellitus; BMI, body mass index.

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  Fig. 2. Risk of cardiovascular disease events and mortality due to lifestyle changes. (A) The prehypertension group; (B) the prediabetes group. For the sensitivity analysis, events occurring 2 years after the observation of the lifestyle changes were excluded and evaluated. MACE, major adverse cardiovascular events; BMI, body mass index.

Reference

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