title: Impact of healthy lifestyle on mortality in people with normal blood pressure, LDL cholesterol, and C-reactive protein.
abstract: BACKGROUND
  To investigate the impact of healthy lifestyle on cardiovascular risk and mortality in people without a history of cardiovascular disease and without elevation of lipid, blood pressure, or inflammatory markers.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Study of a diverse sample of adults in the NHANES III follow-up Mortality Survey, to determine the benefit of adhering to healthy lifestyle habits (five or more fruits and vegetables/day, regular exercise, or being non-obese (body mass index 18.5-29.9 kg/m(2)), no current smoking, moderate alcohol consumption) in adults without common cardiovascular risk factors such as elevated cholesterol (low-density lipoprotein, LDL, cholesterol >130 mg/dl), inflammation (C-reactive protein, CRP, >3.0 mg/l, or hypertension (blood pressure >140/90 mmHg).
  
  
  RESULTS
  Of 11,841 participants, 14.9% were adherent to all five healthy habits. After controlling for age, race, and gender, individuals with lower LDL cholesterol (HR 6.33, 95% CI 2.80-14.30), low CRP (HR 3.48, 95% CI 2.23-5.41), or normal blood pressure (HR 2.87, 95% CI 1.58-5.20) and 0-1 healthy habits had significantly higher all-cause (shown) and cardiovascular mortality than people adhering to all five healthy habits. People without common risk factors and lacking only 1-2 of the healthy habits remained at higher risk of all-cause mortality.
  
  
  CONCLUSIONS
  People without a history of cardiovascular disease who lack common cardiovascular risk factors remain at significantly greater risk of cardiovascular and all-cause mortality if they do not adhere to a healthy lifestyle. Strategies to encourage adopting healthy lifestyles should be implemented among individuals across all risk levels.
authors.affiliation: Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Dana E
authors.initials: DE
authors.lastname: King
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
authors.forename: Eric M
authors.initials: EM
authors.lastname: Matheson
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Everett
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000401:mortality*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL; D002097:C-Reactive Protein