Healthy Lifestyle Change and Subclinical Atherosclerosis in Young Adults: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Study Questions:

What is the association of health behavior changes made earlier in adulthood and the burden and extent of subclinical atherosclerosis in middle age?


This was a post-hoc analysis of the CARDIA (Coronary Artery Risk Development in Young Adults) study. CARDIA was a prospective cohort study in which the following five healthy lifestyle factors (HLFs) were assessed among young adults between ages 18-30 (year 0 baseline) and 20 years later (year 20): not overweight/obese, low alcohol intake, healthy diet, physically active, nonsmoker. The authors determined whether change in HLF score was associated with subclinical atherosclerosis measured by coronary artery calcification (CAC) or carotid intima-media thickness (IMT) at year 20.


In the analytic sample of 3,538 participants and by year 20, 25.3% of the sample improved, 40.4% deteriorated, and 34.4% stayed the same. Each increase in HLFs was associated with reduced odds of CAC (odds ratio, 0.85; 95% confidence interval, 0.74-0.98) and lower IMT (beta = -0.024, p = 0.001).


The authors concluded that change in healthy lifestyle factors from young adulthood to middle age is significantly associated with the presence and extent of subclinical atherosclerosis 20 years later.


The authors provide convincing evidence that making changes in lifestyle behaviors can impact the development of subclinical atherosclerosis. Such findings corroborate the need for promotion (and maintenance) of healthy lifestyle changes.

Clinical Topics: Noninvasive Imaging, Prevention, Atherosclerotic Disease (CAD/PAD), Echocardiography/Ultrasound, Diet

Keywords: Coronary Artery Disease, Life Style, Atherosclerosis, Carotid Intima-Media Thickness, Overweight, Middle Aged, Obesity, Diet, Cost of Illness, Health Behavior

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