Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies.

Zhang YB, Chen C, Pan XF, Guo J, Li Y, Franco OH, Liu G, Pan A.

BMJ · 2021

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Summary

This prospective cohort study of 44,462 US adults and 399,537 UK adults examined relationships between socioeconomic status, healthy lifestyle factors, and cardiovascular mortality. Adults of low socioeconomic status had approximately twice the risk of all-cause mortality compared with high socioeconomic status (hazard ratios 2.13 in US NHANES and 1.96 in UK Biobank). The study suggests that lifestyle factors may partially mediate socioeconomic disparities in health outcomes, with implications for understanding mechanisms linking social inequality to cardiovascular disease burden.

Regional applicability

The study includes UK Biobank data (399,537 UK adults aged 37-73 years), providing direct evidence applicable to United Kingdom populations and policy. The parallel US NHANES cohort allows for transatlantic comparison. Findings on socioeconomic disparities in cardiovascular outcomes are highly relevant to UK health policy and NHS health equity initiatives, though dietary quality assessment and the specific alcohol thresholds used may reflect US dietary guidelines.

Key measures

Hazard ratios for all-cause mortality and CVD by socioeconomic status (low, medium, high); mortality and CVD incidence rates per 1000 person-years; healthy lifestyle score (never smoking, moderate alcohol consumption, top third physical activity, higher dietary quality)

Outcomes reported

All-cause mortality was the primary outcome in both cohorts; cardiovascular disease mortality and incident CVD were also assessed in UK Biobank participants. The study examined whether healthy lifestyle factors mediated associations between socioeconomic status and these health outcomes.

Theme
Nutrition & health
Subject
Dietary patterns & chronic disease
Study type
Research
Study design
Observational cohort
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1136/bmj.n604
Catalogue ID
NRmu2mgrm0-032

Topic tags

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