CARDIOVASCULAR disease risk increased significantly among adults aged 75 years and older who reported unhealthy lifestyle behaviours, according to a large nationwide cohort study of individuals without previous cardiovascular events.
Researchers found a clear association between the accumulation of unhealthy behaviours and the risk of cardiovascular disease, stroke, and myocardial infarction.
The study analysed data from 869,781 adults aged 75 years and older.
Participants were followed for a mean of 6.7 years, during which 120,353 cardiovascular disease events occurred, including 55,117 myocardial infarctions and 74,001 strokes.
An ‘unhealthy lifestyle behaviour’ score assigned one point each for to participants who were currently smoking, heavy drinking, and not regularly exercising.
Researchers observed that cardiovascular disease incidence increased progressively with higher scores.
Rates per 1,000 person years were 17.09 for a score of zero, 20.64 for a score of one, 28.80 for a score of two, and 30.64 for a score of three.
Analysis of individual lifestyle factors showed that current smoking was consistently associated with increased cardiovascular disease, stroke, and myocardial infarction risk.
Non-regular exercise was also associated with elevated risk across all cardiovascular outcomes.
Whereas, heavy drinking was linked to a higher risk of cardiovascular disease and stroke, but not myocardial infarction.
Researchers further observed that combinations of unhealthy behaviours produced a compounded increase in cardiovascular risk, with risk rising as the number of unhealthy behaviours accumulated.
The association between unhealthy lifestyle behaviours and cardiovascular disease risk remained significant despite adjustment for demographic and cardiometabolic factors.
Similar patterns were observed for stroke and myocardial infarction, with stroke risk showing the strongest increase at the highest lifestyle risk scores.
Sub-group analyses indicated stronger associations among female participants, and among individuals without diabetes or dyslipidaemia.
The researchers concluded that lifestyle modification remains clinically relevant in later life and that primary prevention efforts should continue well beyond middle age.
They highlighted smoking cessation and promotion of physical activity as key areas for intervention in adults aged 75 years and older without prior cardiovascular disease.
Choi S et al. Unhealthy lifestyle and cardiovascular disease risk in older adults aged 75+ without prior cardiovascular events: a nationwide cohort study. Sci Rep. 2026;DOI:10.1038/s41598-026-63153-3
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