{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:29:27Z","timestamp":1787754567802,"version":"build-2784847793"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular\u2010kidney\u2010metabolic (CKM) syndrome poses a major health risk. This study assessed the impact of a healthy lifestyle on all\u2010cause and cardiovascular disease (CVD) mortality in CKM individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 306\u2009831 and 9823 CKM individuals from UK Biobank and NHANES (2007\u20132018). A healthy lifestyle score was created based on seven factors: no current smoking, moderate drinking, healthy diet, regular physical activity, adequate sleep, low sedentary behavior and appropriate social connection. Primary outcomes were all\u2010cause and CVD mortality from linked health records and death registries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cox regression models showed that higher lifestyle scores were associated with reduced risks of all\u2010cause (hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.80\u20130.82) and CVD mortality (HR: 0.82, 95% CI: 0.80\u20130.84) in UK Biobank. In NHANES, higher scores were associated with 15% (95% CI: 0.80\u20130.90) and 11% (95% CI: 0.81\u20130.99) lower mortality risks. Both regular physical activity (HRs: 0.85 and 0.89 for UK Biobank, 0.76 and 0.73 for NHANES) and low sedentary behavior (HRs: 0.85 and 0.91 for UK Biobank, 0.79 and 0.67 for NHANES) were related to reduced mortality risks (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Participants with non\u2010advanced CKM syndrome and a favorable lifestyle had the lowest mortality risks compared to those with advanced CKM syndrome and an unfavorable lifestyle.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A healthy lifestyle, particularly regular physical activity and low sedentary behavior, was significantly associated with lower all\u2010cause and CVD mortality in individuals with CKM syndrome. These associations were stronger in the early stages, highlighting the importance of timely and targeted lifestyle interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70436","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T10:23:51Z","timestamp":1785925431000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Healthy Lifestyle With All\u2010Cause and Cardiovascular Disease Mortality in Individuals With Cardiovascular\u2010Kidney\u2010Metabolic Syndrome: Two Prospective Cohort Studies"],"prefix":"10.1002","volume":"49","author":[{"given":"Qiqi","family":"You","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science Xiangyang China"},{"name":"Center for Clinical Evidence\u2010Based and Translational Medicine Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science Xiangyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9107-9540","authenticated-orcid":false,"given":"Wan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science Xiangyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science Xiangyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yucen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron Mitchell","family":"Lett","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Li","sequence":"additional","affiliation":[{"name":"College of Medicine Hubei University of Arts and Science Xiangyang Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menglin","family":"Fan","sequence":"additional","affiliation":[{"name":"Center for Clinical Evidence\u2010Based and Translational Medicine Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science Xiangyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8260-2456","authenticated-orcid":false,"given":"Shaoyong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Xiangyang Central Hospital Affiliated Hospital of Hubei University of 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