Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population

Abstract. Background:. Whether adherence to a healthy lifestyle is associated with a lower risk of developing pneumonia and a better long-term prognosis remains unclear. This study aimed to investigate associations of individual and combined lifestyle factors (LFs) with the incidence risk and long-...

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Main Authors: Yizhen Hu, Qiufen Sun, Yuting Han, Canqing Yu, Yu Guo, Dianjianyi Sun, Yuanjie Pang, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Mengwei Wang, Rebecca Stevens, Junshi Chen, Zhengming Chen, Liming Li, Jun Lv, On behalf of the China Kadoorie Biobank Collaborative Group, Jing Ni, Xuehong Zhang
Format: Article
Language:English
Published: Wolters Kluwer 2025-06-01
Series:Chinese Medical Journal
Online Access:http://journals.lww.com/10.1097/CM9.0000000000003160
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author Yizhen Hu
Qiufen Sun
Yuting Han
Canqing Yu
Yu Guo
Dianjianyi Sun
Yuanjie Pang
Pei Pei
Ling Yang
Yiping Chen
Huaidong Du
Mengwei Wang
Rebecca Stevens
Junshi Chen
Zhengming Chen
Liming Li
Jun Lv
On behalf of the China Kadoorie Biobank Collaborative Group
Jing Ni
Xuehong Zhang
author_facet Yizhen Hu
Qiufen Sun
Yuting Han
Canqing Yu
Yu Guo
Dianjianyi Sun
Yuanjie Pang
Pei Pei
Ling Yang
Yiping Chen
Huaidong Du
Mengwei Wang
Rebecca Stevens
Junshi Chen
Zhengming Chen
Liming Li
Jun Lv
On behalf of the China Kadoorie Biobank Collaborative Group
Jing Ni
Xuehong Zhang
author_sort Yizhen Hu
collection DOAJ
description Abstract. Background:. Whether adherence to a healthy lifestyle is associated with a lower risk of developing pneumonia and a better long-term prognosis remains unclear. This study aimed to investigate associations of individual and combined lifestyle factors (LFs) with the incidence risk and long-term prognosis of pneumonia hospitalization. Methods:. Using data from the China Kadoorie Biobank study, we used the multistate models to investigate the role of five high-risk LFs, including smoking, excessive alcohol drinking, unhealthy dietary habits, physical inactivity, and unhealthy body shape, alone or in combination in the transitions from a generally healthy state at baseline to pneumonia hospitalization or cardiovascular disease (CVD, regarded as a reference outcome), and subsequently to mortality. Results:. Most of the five high-risk LFs were associated with increased risks of transitions from baseline to pneumonia and from pneumonia to death, but with different risk estimates. The greater the number of high-risk LFs, the higher the risk of developing pneumonia and long-term mortality risk after pneumonia, with the strength of associations comparable to that of LFs and CVD. Compared to participants with 0–1 high-risk LF, the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for transitions from baseline to pneumonia and from pneumonia to death in those with five high-risk LFs were 1.43 (1.28–1.60) and 1.98 (1.61–2.42), respectively. Correspondingly, the respective HRs (95% CIs) for transitions from baseline to CVD and from CVD to death were 2.00 (1.89–2.11) and 1.44 (1.30–1.59), respectively. The risk estimates changed slightly when further adjusting for the presence of major chronic diseases. Conclusion:. In this Chinese population, unhealthy LFs were associated with an increased incidence and long-term mortality risk of pneumonia.
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spelling doaj-art-ec43b3fecafb4f6a83be1d73b55e25cc2025-08-20T03:47:21ZengWolters KluwerChinese Medical Journal0366-69992542-56412025-06-01138121456146410.1097/CM9.0000000000003160202506200-00008Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese populationYizhen Hu0Qiufen Sun1Yuting Han2Canqing Yu3Yu Guo4Dianjianyi Sun5Yuanjie Pang6Pei Pei7Ling Yang8Yiping Chen9Huaidong Du10Mengwei Wang11Rebecca Stevens12Junshi Chen13Zhengming Chen14Liming Li15Jun Lv16On behalf of the China Kadoorie Biobank Collaborative GroupJing NiXuehong Zhang1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China5 Fuwai Hospital Chinese Academy of Medical Sciences, Beijing 100037, China1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China3 Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China6 Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK6 Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK6 Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK8 NCDs Prevention and Control Department, Henan CDC, Zhengzhou, Henan 450016, China7 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK9 China National Center for Food Safety Risk Assessment, Beijing 100022, China7 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, ChinaAbstract. Background:. Whether adherence to a healthy lifestyle is associated with a lower risk of developing pneumonia and a better long-term prognosis remains unclear. This study aimed to investigate associations of individual and combined lifestyle factors (LFs) with the incidence risk and long-term prognosis of pneumonia hospitalization. Methods:. Using data from the China Kadoorie Biobank study, we used the multistate models to investigate the role of five high-risk LFs, including smoking, excessive alcohol drinking, unhealthy dietary habits, physical inactivity, and unhealthy body shape, alone or in combination in the transitions from a generally healthy state at baseline to pneumonia hospitalization or cardiovascular disease (CVD, regarded as a reference outcome), and subsequently to mortality. Results:. Most of the five high-risk LFs were associated with increased risks of transitions from baseline to pneumonia and from pneumonia to death, but with different risk estimates. The greater the number of high-risk LFs, the higher the risk of developing pneumonia and long-term mortality risk after pneumonia, with the strength of associations comparable to that of LFs and CVD. Compared to participants with 0–1 high-risk LF, the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for transitions from baseline to pneumonia and from pneumonia to death in those with five high-risk LFs were 1.43 (1.28–1.60) and 1.98 (1.61–2.42), respectively. Correspondingly, the respective HRs (95% CIs) for transitions from baseline to CVD and from CVD to death were 2.00 (1.89–2.11) and 1.44 (1.30–1.59), respectively. The risk estimates changed slightly when further adjusting for the presence of major chronic diseases. Conclusion:. In this Chinese population, unhealthy LFs were associated with an increased incidence and long-term mortality risk of pneumonia.http://journals.lww.com/10.1097/CM9.0000000000003160
spellingShingle Yizhen Hu
Qiufen Sun
Yuting Han
Canqing Yu
Yu Guo
Dianjianyi Sun
Yuanjie Pang
Pei Pei
Ling Yang
Yiping Chen
Huaidong Du
Mengwei Wang
Rebecca Stevens
Junshi Chen
Zhengming Chen
Liming Li
Jun Lv
On behalf of the China Kadoorie Biobank Collaborative Group
Jing Ni
Xuehong Zhang
Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population
Chinese Medical Journal
title Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population
title_full Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population
title_fullStr Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population
title_full_unstemmed Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population
title_short Role of lifestyle factors on the development and long-term prognosis of pneumonia and cardiovascular disease in the Chinese population
title_sort role of lifestyle factors on the development and long term prognosis of pneumonia and cardiovascular disease in the chinese population
url http://journals.lww.com/10.1097/CM9.0000000000003160
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