Prevent cardiovascular disease and stroke: start early

Robin Wulffson MD's picture
hypertension, heat disease, stroke, lifestyle changes, sodium
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Teens and young adults are often not that proactive about their health; however, when they reach middle age and suffer a heart attack or are informed by their physician that they have hypertension or cardiovascular disease, they often go on a health kick. Although a healthier lifestyle still has benefits, in many cases it is too little too late. Cardiovascular disease often has its roots in childhood and the teens.

According to two new studies, a growing body of research notes that engaging in a healthy lifestyle when young is the most effective way to reduce the risk of cardiovascular disease and stroke.

According to a study published in the December issue of the journal Circulation, keeping blood pressure and other risk factors in check over time is much better than playing catch-up when an individual is middle-aged. Furthermore, because blood pressure tends to increase with age, it is particularly important to detect elevated blood pressure early to reduce the mounting risks that come with it. "Cardiovascular disease happens at the average age of 55, so people really don't think about it until they're already at increased risk," noted Norrina Allen, an epidemiologist at Northwestern University Feinberg School of Medicine and one of the study authors. She added, "People with blood pressure at a lower range at one point in time need to be vigilant about keeping it low, and can't assume that they're at low risk for cardiovascular disease."

The researchers reviewed more than 60,000 patient records, incorporating data collected in other research studies spanning 60 years. They compared blood pressure measurements for each patient taken on average at 41 years of age and again at 55. The team then tracked whether the patients suffered strokes, coronary heart disease, or cardiovascular diseases over the next few decades of their lives. They concluded that bringing hypertension under control at any time reduces the risk of cardiovascular disease. However, by preventing it from rising in the first place can be even better. For example, men with high blood pressure (above 140/90) in their 40s who reduced the measurement to between 120/80 and 139/89, which still represents a modest elevation, lowered their risk of cardiovascular disease by their mid-50s to from 65% to 59%.

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Men who maintained moderately elevated blood pressure during the study period had a 51% chance of cardiovascular disease in the remaining years of their life. Furthermore, men with consistently low blood pressure (below 120/80) had a 41% risk. However, the risk for cardiovascular disease soared to 69% for men who had low blood pressure in their 40s and ended up with hypertension.

Another study, published in December in the Journal of the American Medical Association (JAMA), reported similar results, which were based on measurements of the resting heart rate, which is typically lower for healthier patients. An increase in the rate, which is the number of heart beats per minute while seated, over the 10-year study period was associated with a heightened risk of fatal cardiovascular disease. Individuals who maintained lower or normal rates had lower risk. The study, comprised of 29,000 individuals, was conducted by researchers at the Norwegian University of Science and Technology.

Take home message:
Obviously, a healthy lifestyle is most beneficial to an individual who starts at an early age; however, benefits can be obtained at any age—even after an adverse event such as a heart attack or stroke. Shedding excess pounds, a healthy diet, and an exercise program can do a world of good. It is not only important to limit sodium in one’s diet but also to maintain a higher level of potassium. A low sodium to potassium ratio has proven to be beneficial. Smoking (both tobacco and marijuana) is a major cardiovascular risk factor—as well as the risk of lung cancer and chronic obstructive pulmonary disease (COPD). Also, it is important to note that a blood pressure of 120/80 may be elevated for an individual of small stature (i.e., a small woman, a Thai, or a Vietnamese).

References:
Circulation
JAMA

See Also:
New Years health tip: less sodium, more potassium

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