In a new study, researchers found that combining healthy lifestyle interventions reduces heart disease through beneficial effects on different lipoproteins and associated cholesterols.
The finding provides more detailed information on how healthy lifestyles improve cholesterol and suggests that combining cholesterol-lowering medications and lifestyle interventions may provide the greatest benefits to heart health.
The research was conducted by a team at Harvard T.H. Chan School of Public Health.
Having a healthy lifestyle has long been linked to a lower risk of developing heart disease.
Cholesterol-lowering medications such as statins help reduce heart risks by lowering levels of low-density lipoprotein (LDL) cholesterol, the so-called ‘bad’ cholesterol.
Healthy lifestyle interventions, including exercising regularly, having a healthy diet, lowering alcohol consumption and maintaining a healthy weight, have also been shown to lower LDL as well as increase ‘healthy’ high-density lipoprotein (HDL) cholesterol.
In the study, the team measured 61 different lipid markers in blood samples from 4,681 participants in the China Kadoorie Biobank, including cases of stroke, coronary heart disease and healthy people.
They studied lipid markers in the blood of participants who had multiple healthy lifestyle habits and compared them to those of participants with less healthy habits.
They found 50 lipid markers associated with a healthy lifestyle.
When the team looked at a subset of 927 people who had coronary heart disease in the next 10 years and 1,513 healthy people, they found 35 lipid markers that showed strong effects in the pathway from healthy lifestyles to the reduction of heart disease.
Together, the combined beneficial effects of the lipid changes linked to healthy lifestyle practices were linked to a 14% reduced risk of heart disease.
Specifically, very-low-density lipoprotein (VLDL) and HDL levels in the blood were linked to the heart-protecting benefits of healthy lifestyles.
The findings confirmed that cholesterol-lowering drugs would have the expected effect in lowering LDL cholesterol, but this is much weaker compared to the effect of healthy behaviors on VLDL cholesterol which also increases the risk of heart disease.
Overall, the team found that taking cholesterol-lowering medications and engaging in multiple healthy lifestyles would likely help people to achieve the greatest heart-protecting benefits because of the complementary effects of the drugs and healthy behaviors.
They say lifestyle interventions and lipid-lowering medications may affect different components of the lipid profile, suggesting they are not redundant strategies but could be combined for improved benefits.
One author of the study is Jiahui Si, Postdoctoral Research Fellow in the Department of Epidemiology.
The study is published in eLife.
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