Optimal lifestyle behaviors and 10-year progression of arterial stiffness: The Multi-Ethnic Study of Atherosclerosis

Yacob Ghirmatsion Tedla*, Adam Gepner, James H. Stein, Joseph A. Delaney, Chia Ying Liu, Philip Greenland

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Majority of previous studies showed no association between a single health behavior and arterial stiffness, but the benefit of simultaneously having multiple healthy behaviors (optimal lifestyle) on the progression of arterial stiffness is unknown. Among 2810 individuals (age 60.0 ± 9.4, 46.5% male), optimal lifestyle marker (yes/no) on four health behaviors (ie, BMI < 25 kg/m2, never or former smoker, never or moderate drinker, exercised > 500 METS min/week) across four visits (≈ 5 years) were summed to create an optimal lifestyle score. Carotid arterial stiffness was measured using distensibility coefficient (DC) and Young's elastic modulus (YEM) at visit 1 and after a mean of 9.5 years (visit 5). The association of optimal lifestyle with 10-year percent change in DC and YEM was assessed using multiple linear regression. DC decreased by 5.3% and YEM increased by 24.4% over 10 years. Mean optimal lifestyle score was 9.4 ± 3.1 (range: 0–16). Individuals in quintiles 2–5 of optimal lifestyle score compared to quintile 1 (with the least optimal lifestyle score) did not show slower deceleration of DC [Q2, −0.3% (95% CI: −6.0, 5.4); Q3, −0.01% (−4.5, 4.5); Q4, −0.6% (−5.2, 3.9); Q5, −0.4% (−5.3, 4.4)], trend p-value =.82] or slower progression of YEM [Q2, 0.1% (−7.1, 7.3); Q3, −0.8% (−8.0, 6.5); Q4, 4.5% (−2.3, 11.3); Q5, −0.2% (−8.3, 7.9)], trend p-value =.49] after adjusting for risk factors. The association remained non-significant when stratified by categories of age, sex, race, BP control, and diabetes. Our findings indicate that optimal score on multiple health behaviors may not independently slow arterial stiffness progression.

Original languageEnglish (US)
Pages (from-to)401-408
Number of pages8
JournalJournal of Clinical Hypertension
Issue number4
StatePublished - Apr 2022


  • alcohol
  • arterial stiffness
  • body mass index
  • exercise
  • healthy lifestyle
  • smoking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


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