Risk for Heart Disease
Study Examines How Middle-Age Risk Factors Drive Greater Lifetime Risk for Cardiovascular Disease
A recently-published study in the New England Journal of Medicine reports that while an person's risk of heart disease may be low in the next five or 10 years, the lifetime risk could still be very high; These findings could have implications for both clinical practice and public health policy.
"The current approach to heart disease prevention focuses on only short-term risks, which can give a false sense of security, particularly to individuals in their 40s and 50s," said research scientists at UT Southwestern Medical Center.
"Early life decisions we make can have a significant
impact on the rest of our lives and heart healthy choices are no different. The risk factors we develop in younger and middle ages are going to determine our heart disease risk across our lifetime."
Medical experts have long established that the presence of risk factors was a predictor of heart disease across time, gender and race. The new research noted that the concept of lifetime risk represents an important change in how individuals and their physicians will approach heart disease risk and prevention.
"If we want to reduce cardiovascular disease, we need to prevent the development of risk factors in the first place," they said. "What determines your heart disease risk when you are 70 or 80 is
what your risk factors are when you're 40."
Examining the results of longitudinal studies over the past 50 years, researchers found that people with two or more major risk factors in middle-age had dramatically higher lifetime risks for heart disease and cardiovascular death, myocardial infarction and stroke across the lifespan. It's important to recognize similar trends were observed across all race and age groups.
The scientists used data collected in the Cardiovascular Lifetime Risk Pooling Project,
measuring risk factors of more than 254,000 participants, including black and white men
and women at ages 45, 55, 65 and 75 years. Individuals with multiple risk factors had
substantially higher lifetime risks for heart
disease, as much as 10 times the rates of
those people without risk factors in some
heart disease categories.
Most previous studies on heart disease risk estimates have focused on short-term risk
over a five- or 10-year period. Heart disease is much more common in older age, and therefore, nearly all individuals younger than 50 are considered low-risk. "But most adults in the U.S. considered low-risk in the short term are actually
at high risk across their remaining life span," the researcher said.
This latest study also showed that the decline
in cardiovascular disease rates over the past
several decades reflects changes in the prevalence of the risk factors rather than access to and effects of better treatment. Smoking and cholesterol levels
have fallen in recent decades, for instance, due to behavioral changes in the general population.
Nevertheless, researchers found that the long-term risk for cardiovascular disease within each risk factor group has remained similar. "Regardless of where you were born or when you were born, the effects of risk factors on lifetime risk for heart disease are about the same," they emphasized.
Preventing the development of risk factors in the first place will be more effective than treating the effects of these risk factors once they develop, researchers concluded. The study was funded by the National Heart, Lung and Blood Institute.
Senior author of the study was Dr. Donald Lloyd-Jones, chairman of preventive medicine at Northwestern University Feinberg School of Medicine. Other scientists from Feinberg
School of Medicine, the University of Minnesota
and the University of Vermont College of
Medicine also participated in the research.
Story Source:
UT Southwestern Medical Center
Journal Reference:
Lifetime Risks of Cardiovascular Disease. New England Journal of Medicine, 2012;
UT Southwestern Medical Center (2012, January 25). Middle-age risk factors drive greater lifetime risk for heart disease.
This article is for informational and educational purposes only; It is not intended to provide medical advice, diagnosis or treatment. Consult your doctor orhealthcare professional.
