Aspects of cardiovascular risk in an Australian population study

Prevention of cardiovascular disease (CVD), a leading cause of death in men and women, is both a global and national public health priority. Prevention efforts have generally focused on well-known lifestyle (e.g., physical inactivity, unhealthy diet, smoking) and metabolic (e.g., overweight/obesity, hypertension, hyperlipidaemia) risk factors. It is also important for public health strategies to consider emerging risk factors, innovative approaches to risk factors, and evidence in middle-aged men and women, to develop effective prevention strategies. This thesis explored innovative aspects of cardiovascular risk in a large cohort of middle-aged and older Australian men and women (“the 45 and Up Study”) by examining: 1) emerging or lesser known risk factors such as raw vegetable intake (Chapter 3), sedentary behaviour (Chapter 4, Appendix 1) and psychological distress (Chapter 5); 2) the single versus joint influence of lifestyle risk factors on incident type 2 diabetes (Chapter 4, Appendix 1) and hypertension (Chapter 5); 3) potential gender differences (Chapters 3-5, Appendix 1), and female-specific behaviours such as breastfeeding (Chapters 6-7). Overall, findings support Australian recommendations for fruit and vegetable intake, physical activity, alcohol intake and infant breastfeeding. While the importance of reducing known risk factors for CVD prevention was evident, the role of raw vegetable intake, sedentary behaviour and psychological distress was inconclusive. Breastfeeding was associated with a lower maternal risk of CVD. Findings confirmed that adopting a cluster of healthy lifestyle behaviours can reduce CVD risk in the middle-aged and older population. Potential gender differences were explored and identified. This thesis contributes to the literature by exploring innovative aspects of cardiovascular risk that are relevant to middle-aged adults, particularly women, as well as informs health care providers, researchers and policy makers