Diabetes, hypertension, high cholesterol, smoking. These have long been recognized as major risk factors for cardiovascular disease. Now, a study just published in the New England Journal of Medicine starkly demonstrates just how significantly these factors increase a person’s risk of stroke or heart attack. But the good news, say the study authors, is that these factors are lifestyle-related; that is, they are, to a large extent, within a person’s control.
Researchers, led by the chair of preventive medicine at Northwestern University’s Feinberg School of Medicine, examined 18 studies whose participants totaled more than 250,000 people assessed at age 45, 55, 65, or 75. Using the four cardiovascular risk factors mentioned above, the researchers estimated the lifetime risks of cardiovascular disease, heart attack, and stroke. What they found was striking. For instance, a 45-year-old man with none of the four risk factors had only a 1.4 percent chance of having a major heart event or stroke during the remainder of his lifetime. Yet a 45-year-old man with two or more of these risk factors, the researchers found, had a lifetime risk of 49.5 percent. The estimates for men and women were similar, regardless of whether they were black or white.
The study emphasizes just how important a role lifestyle plays when it comes to cardiovascular health. As the authors observed, if a person can reach middle age with none of these risk factors, their chances of stroke or heart attack are reliably low. And as for those who do have these risk factors, perhaps the best news is that lifestyle changes and medications can lower their risk, although significant effort is involved.
ACSH’s Dr. Josh Bloom was impressed by the study’s striking results. “Having just two of these risk factors makes for an incredible difference in overall risk,” he notes. “The bottom line is that lifestyle really does matter.” Dr. Bloom points out that, even those who find themselves facing a number of these cardiovascular risk factors can modify those risks with the help of blood pressure medications, cholesterol-lowering drugs, weight control, and smoking cessation.
“Easy enough to say, devilishly difficult to accomplish,” says ACSH’s Dr. Gilbert Ross. He conjectures that being able to show their patients such concrete numbers about the risk they’re taking might be a very helpful tool for physicians in their struggle to improve patients’ health. “Theoretically, at least,” he says, “such stark numbers might inspire people to take charge of their risk factors.”
