To examine the long-term effects of lifestyle on the recovery from risk factors of cardiovascular disease and to discuss the difference in the effects of lifestyle modification in subjects with a single risk factor and those with multiple risk factors.

We used checkup data compiled for 6477 male workers, aged 20–59 years in 1995, with risk factors of cardiovascular disease. The relation between the recovery from risk factors 9 years later and baseline lifestyles was examined by logistic regression according to the initial number of risk factors.

Nine years following the baseline measurements, 1907 subjects had recovered from at least one risk factor. When there was initially a single risk factor, a good overall lifestyle was effective in the recovery [odds ratio (OR) 1.27; 95% confidence interval (CI) 1.03, 1.57], with maintaining good dietary habits (OR 1.24; 95% CI 1.07, 1.45) and moderate stress levels (OR 1.19; 95% CI: 1.03, 1.38) both found to be especially effective in the recovery. When there were multiple risk factors, although the effect of a good overall lifestyle on the recovery was less than that when there was only a single risk factor, non-smoking (OR 1.27; 95% CI 1.07, 1.51) and limiting working hours (OR 1.25; 95% CI 1.05, 1.49) were found to be effective.

Our results provide evidence that good lifestyles are effective in the recovery from multiple risk factors. Effects of lifestyle on recovery from multiple risk factors are different from effects on the recovery from a single risk factor, with the difference depending on the initial number of risk factors.