The Influence of Lifestyle Modifications on Cardiovascular Outcomes in Older Adults: Findings from a Cross-Sectional Study

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among older adults. Lifestyle modifications, including diet, physical activity, and smoking cessation, are key to reducing cardiovascular risk. This study examines the combined effects of these behaviors on cardiovascular outcomes and their mediating mechanisms. Methods: A cross-sectional study was conducted among older adults (aged >= 60 years) in Riyadh, Saudi Arabia. Data on dietary quality, physical activity, and smoking status were collected using validated questionnaires. Cardiovascular outcomes, including low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), and body mass index (BMI), were measured. A composite cardiovascular risk score was computed. Path analysis was employed to assess direct and indirect effects of lifestyle factors on cardiovascular outcomes. Results: Participants adhering to a healthy diet, engaging in regular physical activity, and avoiding smoking had significantly lower composite cardiovascular risk scores. Non-smoking status showed the strongest direct effect (beta = -0.20, p = 0.006), while dietary quality and physical activity exhibited significant indirect effects mediated by LDL, SBP, and BMI. Combined adherence to multiple healthy behaviors resulted in the greatest reductions in cardiovascular risk. The path analysis highlighted dietary quality and physical activity as critical mediators of cardiovascular health improvements. Conclusions: Lifestyle modifications significantly reduce cardiovascular risk in older adults, with cumulative benefits observed for combined adherence to healthy behaviors. These findings emphasize the importance of comprehensive lifestyle interventions targeting diet, physical activity, and smoking cessation to promote cardiovascular health in aging populations.