A healthy lifestyle attenuates the effect of polypharmacy on total and cardiovascular mortality: a national prospective cohort study
EntityUAM. Departamento de Educación Física, Deporte y Motricidad Humana; UAM. Departamento de Medicina Preventiva y Salud Pública y Microbiología
PublisherNature Research (part of Springer Nature):
10.1038/s41598-018-30840-9Scientific Reports 8 (2018): 12615
Funded byThis work was supported by FIS grants 16/609 and 13/0288 (Instituto de Salud Carlos III, State Secretary of R + D + I and FEDER/FSE), MINECO R + D + I grant (DEP2013-47786-R), the FRAILOMIC Initiative (European Union FP7-HEALTH-2012-Proposal No. 305483-2), and the ATHLOS project (European project H2020- Project ID:635316)
ProjectGobierno de España. FIS 16/609; Gobierno de España. FIS 13/0288; Gobierno de España. DEP2013-47786-R; info:eu-repo/grantAgreement/EC/FP7/305483-2; info:eu-repo/grantAgreement/EC/H2020/635316/EU//ATHLOS
SubjectsCardiovascular disease; Polypharmacy; Cohort study; Healthy lifestyle; Educación; Medicina
Rights© 2018, The Author(s).
Esta obra está bajo una Licencia Creative Commons Atribución 4.0 Internacional.
This work examines whether the increased all-cause and cardiovascular disease (CVD) mortality associated with polypharmacy could be offset by a healthy lifestyle. We included a prospective cohort of 3,925 individuals representative of the Spanish population aged ≥60 years, who were recruited in 2000–2001 and followed up through 2014. Polypharmacy was defined as treatment with ≥5 medications. The following lifestyle behaviors were considered healthy: not smoking, eating a healthy diet, being physically active, moderate alcohol consumption, low sitting time, and adequate sleep duration. Individuals were classified into three lifestyle categories s: unfavorable (0–2), intermediate (3–4) favorable (5–6). Over a median 13.8-y follow-up, 1,822 all-cause and 675 CVD deaths occurred. Among individuals with polypharmacy, intermediate and favorable lifestyles were associated with an all-cause mortality reduction (95% confidence interval [CI]) of 47% (34–58%) and 54% (37–66%), respectively; 37% (9–56%) and 60% (33–76%) for CVD death, respectively. The theoretical adjusted hazard ratio (95%CI) associated with replacing 1 medication with 1 healthy lifestyle behavior was 0.73 (0.66–0.81) for all-cause death and 0.69 (0.59–0.82) for CVD death. The theoretical adjusted hazard ratio (95%CI) for all-cause and CVD mortality associated with simply reducing 1 medication was 0.88 (0.83–0.94) and 0.83 (0.76–0.91), respectively. Hence, adherence to a healthy lifestyle behavior can reduce mortality risk associated with polypharmacy in older adults.
Google Scholar:Martínez-Gómez, David - Guallar Castillón, María Pilar - Higueras-Fresnillo, Sara - Banegas Banegas, José Ramón - Sadarangani, Kabir P. - Rodríguez Artalejo, Fernando
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