Original Article

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

Yeji Kim1, Shinjeong Song2, Chang Mo Moon4, Hye Ah Lee3,*, Junbeom Park2,**
Author Information & Copyright
1Department of Cardiology, Korea University Anam Hospital , Seoul 02841, Korea.
2Department of Cardiology, Ewha Womans University Medical Center, Seoul 07985, Korea.
3Clinical trial center, Ewha Womans University Medical Center, , Seoul 07985, Korea.
4Department of Gastroenterology, Ewha Womans University Medical Center, Seoul 07985, Korea.
**Corresponding Author: Hye Ah Lee, Clinical trial center, Ewha Womans University Medical Center, , Seoul 07985, Korea, Republic of. E-mail: khyeah@ewha.ac.kr.
**Corresponding Author: Junbeom Park, Department of Cardiology, Ewha Womans University Medical Center, Seoul 07985, Korea, Republic of. E-mail: newriser@naver.com.

© Copyright 2024 Ewha Womans University School of Medicine. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Sep 20, 2024; Accepted: Sep 26, 2024

Published Online: Oct 31, 2024

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.

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