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Epidemiology Research International
Volume 2013 (2013), Article ID 437465, 9 pages
http://dx.doi.org/10.1155/2013/437465
Clinical Study

Percentage of Deaths Attributable to Poor Cardiovascular Health Lifestyle Factors: Findings from the Aerobics Center Longitudinal Study

1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
2Beijing Sport University, Beijing 100084, China
3Department of Biostatistics and Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
4Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
5Department of Health Examination Center, Beijing Hospital, Beijing 100050, China

Received 2 April 2013; Accepted 2 July 2013

Academic Editor: Jaume Marrugat

Copyright © 2013 Xuemei Sui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. We assessed the effects of the four newly defined American Heart Association (AHA) lifestyle factors on mortality by examining the associated population attributable fractions (PAFs) of these factors. Methods. Slightly modified AHA cardiovascular health factors (smoking, body mass index, cardiorespiratory fitness, and diet) were measured among 11,240 (24% women) participants from the Aerobics Center Longitudinal Study between 1987 and 1999. The cohort was followed to December 31, 2003, or death. PAFs were calculated as the proportionate reduction in death attributable to identified risk factors. Results. During an average 12 years of followup, 268 deaths occurred. Low fitness had the highest PAFs at the 5th, 10th, and 15th year of followup, respectively: 6.6%, 6.4%, and 5.5%. Current smokers had the second highest PAFs at the 5th, 10th, and 15th year of followup, respectively: 5.4%, 5.2%, and 5.0%. Additional adjusting for other confounders in the model did not change the above associations. The PAFs for overweight or obesity and unhealthy diet were not significant in the current analyses. Conclusions. Assuming a causal relationship between smoking, low fitness, and mortality, avoidance of both would have prevented 13% of the deaths in the current population. Preventive interventions to increase physical activity and stop smoking would most likely promote longevity.