Table 3.

Incidence Rates and Hazard Ratios of All-Cause Mortality Associated With Healthy Lifestyle Factors Among Participants With a 10-year Predicted Atherosclerotic Cardiovascular Disease Risk ≥7.5% (n=5,709).

	Events / n at risk	Crude incidence rate per 1,000 person years (95% confidence interval)	Hazard Ratio (95% confidence interval)
			Model 1a	Model 2b
	Individual healthy lifestyle factors
Waist circumference
Obese	193 / 2,459	13.29 (11.42, 15.17)	1 (ref)	1 (ref)
Non-obese	278 / 3,250	14.15 (12.49, 15.82)	0.94 (0.78, 0.14)	1.05 (0.86, 1.29)
Physical activity
None	167 / 1,720	16.65 (14.11, 19.19)	1 (ref)	1 (ref)
1 – 4 times per week	177 / 2,501	11.72 (9.98, 13.45)	0.68 (0.55, 0.85)	0.73 (0.59, 0.91)
≥ 5 times per week	127 / 1,488	14.09 (11.63, 16.56)	0.77 (0.61, 0.98)	0.83 (0.65, 1.06)
p-trend			0.023	0.110
Smoking status
Current	136 / 1,100	22.18 (18.45, 25.91)	1 (ref)	1 (ref)
Nonsmoker	335 / 4,609	11.95 (10.67, 13.23)	0.35 (0.29, 0.44)	0.39 (0.32, 0.49)
Saturated fat intake
≥ 7.0% of daily calories	437 / 5,294	13.84 (12.52, 15.15)	1 (ref)	1 (ref)
< 7.0% of daily calories	34 / 415	13.21 (8.15, 18.27)	0.89 (0.59, 1.35)	0.93 (0.60, 1.42)
Mediterranean diet scorec
Quartile 1 (worse)	177 / 1,793	16.94 (14.31, 19.57)	1 (ref)	1 (ref)
Quartile 2	111 / 1,143	16.25 (12.91, 19.59)	0.94 (0.72, 1.21)	0.95 (0.73, 1.22)
Quartile 3	83 / 1,191	11.52 (8.81, 14.24)	0.65 (0.49, 0.88)	0.70 (0.52, 0.94)
Quartile 4 (better)	100 / 1,582	10.34 (8.04, 12.65)	0.57 (0.43, 0.77)	0.61 (0.46, 0.82)
p-trend			<0.001	<0.001
	Number of healthy lifestyle factorsd
0	21 / 289	20.55 (13.31, 27.79)	1 (ref)	1 (ref)
1	118 / 1,649	15.89 (13.26, 18.51)	0.51 (0.34, 0.75)	0.54 (0.37, 0.80)
2	134 / 2,104	13.07 (10.90, 15.24)	0.35 (0.23, 0.53)	0.40 (0.26, 0.60)
3	81 / 1,238	12.56 (9.91, 15.21)	0.32 (0.21, 0.48)	0.38 (0.25, 0.59)
≥ 4	23 / 429	9.21 (5.26, 13.16)	0.23 (0.13, 0.40)	0.28 (0.16, 0.50)
p-trend			<0.001	<0.001

^aModel 1: adjustment for age, race, sex, education, income and geographic region of residence.

^bModel 2: adjustment for Model 1 variables plus high-density lipoprotein and total cholesterol, c-reactive protein >3 mg/L, systolic and diastolic blood pressure, antihypertensive medication use, albumin-to-creatinine ratio ≥30 g/mg and estimated glomerular filtration rate <60 ml/min/1.73 m².

^cQuartiles determined using all participants.

Mediterranean diet score cut-points: [quartile 1 (low) to quartile 4 (high)] <3, 3 to <4, 4 to <6, and ≥6.

^dNumber of healthy lifestyle factors: the sum of a non-obese waist circumference (<102 cm for men and <88 cm for women), physical activity ≥ 5 times per week, nonsmoking, saturated fat intake < 7.0% of average daily calories and Mediterranean diet score in quartile 4.