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A healthy lifestyle, particularly regular physical activity and low sedentary behavior, is associated with reduced all-cause and cardiovascular disease mortality in individuals with cardiovascular-kidney-metabolic syndrome.

In two prospective cohorts (UK Biobank and NHANES), higher healthy lifestyle scores were associated with significantly lower risks of all-cause and CVD mortality. For example, in UK Biobank, each unit increase in lifestyle score was linked to a 19% lower all-cause mortality risk (HR 0.81) and an 18% lower CVD mortality risk (HR 0.82). The associations were stronger in early stages of CKM syndrome.

Last updated: Aug 9, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Associations of Healthy Lifestyle With All-Cause and Cardiovascular Disease Mortality in Individuals With Cardiovascular-Kidney-Metabolic Syndrome: Two Prospective Cohort Studies.

observational

You Q, Fu W, Xu M, Wu Y, Lett AM, Li X, Fan M, Xu S · Clinical cardiology (2026)

Participants: 316654
Duration: Not specified (prospective cohorts with follow-up)
Intervention: Healthy lifestyle score based on seven factors: no current smoking, moderate drinking, healthy diet, regular physical activity, adequate sleep, low sedentary behavior, and appropriate social connection.
Outcome: All-cause mortality and cardiovascular disease mortality.
Effect Size: UK Biobank: HR=0.81 (95% CI 0.80-0.82) for all-cause mortality; HR=0.82 (95% CI 0.80-0.84) for CVD mortality. NHANES: HR=0.85 (95% CI 0.80-0.90) for all-cause; HR=0.89 (95% CI 0.81-0.99) for CVD.
Population: Individuals with cardiovascular-kidney-metabolic (CKM) syndrome: 306,831 from UK Biobank and 9,823 from NHANES (2007-2018).

Result: In two prospective cohorts (UK Biobank and NHANES), higher healthy lifestyle scores were associated with significantly lower risks of all-cause and CVD mortality. For example, in UK Biobank, each unit increase in lifestyle score was linked to a 19% lower all-cause mortality risk (HR 0.81) and an 18% lower CVD mortality risk (HR 0.82). The associations were stronger in early stages of CKM syndrome.

PubMed: 42554187DOI: 10.1002/clc.70436

Mechanism Graph

Healthy lifestyle factors reduce metabolic and cardiovascular risk factors (e.g., blood pressure, cholesterol, glucose).
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Regular physical activity and low sedentary behavior improve cardiovascular fitness and reduce inflammation.
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Adequate sleep and social connection may reduce stress and improve hormonal balance.
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These combined effects lower the risk of mortality in CKM syndrome.

Limitations

  • ⚠Observational study design, so causality cannot be established.
  • ⚠Lifestyle factors were self-reported, which may introduce measurement error.
  • ⚠Residual confounding from unmeasured variables is possible.
  • ⚠The study population may not be fully representative of all CKM patients.

Frequently Asked Questions

What is cardiovascular-kidney-metabolic (CKM) syndrome?▼

CKM syndrome is a condition that includes cardiovascular disease, kidney disease, and metabolic disorders (like diabetes) that often coexist and increase mortality risk.

Which lifestyle factors were included in the healthy lifestyle score?▼

The score included no current smoking, moderate drinking, healthy diet, regular physical activity, adequate sleep, low sedentary behavior, and appropriate social connection.

How much did mortality risk decrease with a higher lifestyle score?▼

In UK Biobank, each unit increase in score was associated with a 19% lower all-cause mortality risk and an 18% lower CVD mortality risk. In NHANES, the reductions were 15% and 11%, respectively.

Are the benefits of a healthy lifestyle stronger in early or advanced CKM syndrome?▼

The benefits were stronger in non-advanced CKM syndrome stages, suggesting that early lifestyle interventions are particularly important.

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References

  1. 1.You Q, Fu W, Xu M, Wu Y, Lett AM, Li X, Fan M, Xu S. "Associations of Healthy Lifestyle With All-Cause and Cardiovascular Disease Mortality in Individuals With Cardiovascular-Kidney-Metabolic Syndrome: Two Prospective Cohort Studies.." Clinical cardiology, 2026. PMID: 42554187 DOI: 10.1002/clc.70436
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.