Aug. 19, 2003 — About nine in 10 people who suffer a heart attack or death due to heart disease already had at least one of four major heart disease risk factors.
And these four risk factors — cigarette smoking, diabetes, high blood pressure, and high cholesterol levels — are for the most part modifiable.
“It is increasingly clear that the four conventional risk factors and their resulting health risks are largely preventable by a healthy lifestyle,” write researcher Umesh N. Khot, MD, of Indiana Heart Physicians, and colleagues.
Two new studies published this week in The Journal of the American Medical Association debunk the common theory that the four major heart disease risk factors only account for about 50% of all heart attacks and other forms of plaque-related heart disease.
Instead, the studies show that 87%-100% of people who had a fatal heart attack had at least one heart disease risk factor, and 92% of men and 87% of women aged 40 to 59 who had a nonfatal heart attack also had at least one of the following risk factors:
- Total cholesterol level of at least 240 mg/dL
- Blood pressure of at least 140/90
- Cigarette smoking
Debunking the “Only 50%” Myth
Researchers say although the four major heart disease risk factors are well recognized, many studies have shown that some of the risk factors are absent in people who develop heart disease. This has led to a common perception among doctors that a large proportion, up to 50%, of heart disease cases may not be attributable to major, modifiable heart disease risk factors.
In the first study, researcher Phillip Greenland, MD, of Northwestern University in Chicago, and colleagues looked at how often any of these risk factors preceded fatal or nonfatal heart attacks and other major heart problems in three large studies of people with heart disease, which involved nearly 400,000 men and women.
They found that between 87%-100% of people who had a fatal heart attack had at least one of the four major, modifiable heart disease risk factors, and about 90% of people who suffered a nonfatal heart attack also had at least one of the risk factors.
In the second study, researchers found that 85% of women and 81% of men with heart disease had at least one of the four major heart disease risk factors. And except for smoking, all the risks factors were present more in women than in men.
Their study included information gathered from 122,458 heart patients enrolled in 14 international clinical trials in the last decade.
In fact, the link between the risk factors and heart disease was even stronger among younger patients, such as women under 65 and men under 55 who had been treated for chest pain or other serious heart conditions. Only 10%-15% of these patients lacked having one of the four major heart disease risk factors.
Proof that a Healthy Lifestyle Lowers Risk
The researchers conclude that focusing on modifying these risk factors, such as by following a healthy lifestyle, has a great potential to reduce the worldwide epidemic of heart disease.