New York, Feb 17: Combining healthy lifestyle interventions reduces heart disease through beneficial effects on different lipoproteins and associated cholesterols, a new study suggests.

The study, published in the journal eLife, indicated that combining cholesterol-lowering medications and lifestyle interventions may yield the greatest benefits to heart health.

"Until now, no studies have compared the lipid-lowering effects of cholesterol-lowering medications and healthy lifestyle interventions side by side," said lead author Jiahui Si, from Harvard University in the US.

Cholesterol-lowering medications such as statins help reduce heart risks by lowering levels of low-density lipoprotein (LDL) cholesterol, the so-called "bad" cholesterol.

Healthy lifestyle interventions, including exercising regularly, having a healthy diet, lowering alcohol consumption and maintaining a healthy weight, have also been shown to lower LDL as well as increase "healthy" high-density lipoprotein (HDL) cholesterol.

For the study, the team used a technique to measure 61 different lipid markers in blood samples from 4,681 participants, including cases of stroke, coronary heart disease and healthy individuals.

They studied lipid markers in the blood of participants who had multiple healthy lifestyle habits and compared them to those of participants with less healthy habits. They found 50 lipid markers associated with a healthy lifestyle.

When the team looked at a subset of 927 individuals who had coronary heart disease in the next 10 years and 1,513 healthy individuals, they found 35 lipid markers that showed statistically significant mediation effects in the pathway from healthy lifestyles to the reduction of heart disease.

Together, the combined beneficial effects of the lipid changes associated with healthy lifestyle practices were linked to a 14 per cent reduced risk of heart disease, the team said.

Specifically, very-low-density lipoprotein (VLDL) and HDL levels in the blood were linked to the heart-protecting benefits of healthy lifestyles, they added.

Overall, they found that taking cholesterol-lowering medications and engaging in multiple healthy lifestyles would likely help individuals to achieve the greatest heart-protecting benefits because of the complementary effects of the drugs and healthy behaviours.