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New study on minimizing the lifetime risk of cardiovascular disease

Robin Wulffson MD's picture
heart health, cardiovascular health, healthy lifestyle, heart attack stroke

A new study may cause individuals who consider themselves to be at low-risk for cardiovascular disease to reevaluate their current lifestyle. Risk calculators for heart disease, such as the Framingham 30-year risk calculator, are available online; they can provide one with a report regarding the risk of a heart attack or stroke over the next five to 10 years.

If the calculator reports one is at low risk, he or she may be empowered with a sense of invincibility and continue on an unhealthy lifestyle. A new study, published in the January 26 edition of The New England Journal of Medicine might give those high-living individuals cause to reconsider their not-to-worry lifestyle.

The study found that even when a middle-aged individual’s risk was low, his or her lifetime risk could still be dangerously high. The authors wrote: “The majority of adults in the United States who are considered to be at low risk for cardiovascular disease in the short term are actually at high risk across their remaining lifespan.” They added that focusing on short term risks may be giving people a false sense of security, or in other words, a license to continue with some of their unhealthy lifestyles. “The risk factors we develop in younger and middle ages are going to determine our heart disease risk across our lifetime,” noted the study’s lead author Dr. Jarett Berry, MD, assistant professor of internal medicine at University of Texas Southwestern Medical Center. He explained, “What determines your heart disease risk when you are 70 or 80 is what your risk factors are when you’re 40.”

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The researchers reviewed data collected in the Cardiovascular Lifetime Risk Pooling Project of more than 254,000 participants over the last 50 years. They found that people with two or more major risk factors by age 45 or 55 had markedly higher lifetime risks for cardiovascular death, heart attack and stroke across their lifespan. The risk was as much as 10 times greater than that of individuals without risk factors. For example, the lifetime risk of ever having a heart attack for a 45-year-old man with no risk factors is 1.7% compared to a lifetime risk of 42% if he had two major risk factors at age 45. Major risk factors included diabetes, high cholesterol (or being treated for it), hypertension (or being treated for it), and smoking.

“If we want to continue to make progress in reducing cardiovascular disease, we have to address the onset of these risk factors in early life,” said Dr. Berry, who is calling for a greater focus on long term risks, especially for young people, who may have 40 or 50 more years to live. He noted that the take home message of the study was that if you are young, you have to do more to lower your risks or prevent risks altogether. He explained, “We’re giving younger patients the wrong message by focusing on short term risks.”

The Framingham 30-year risk calculator can be accessed with this link. Dr. Berry believes that an even longer risk projection tool is indicated for younger people.

Reference: New England Journal of Medicine

See Also: Prevent cardiovascular disease and stroke: start early