ER 1/25 4 PM CST Longterm Heart Risk Predictions May be Deceptive

Heart attack or stroke risks calculations for next decade may be misleading

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The common practice of predicting the risk of heart attack and stroke a decade into the future might be giving some patients a false sense of security.

Even if a young or middle-aged person has a low short-term risk for heart disease, they could be at a considerably higher risk over the long haul if they have as few as one or two risk factors, such as hypertension or high cholesterol.

"Protect your heart by giving up cigarettes."

Dr. Donald Lloyd-Jones, principal investigator, chair and associate professor of preventive medicine at Northwestern University Feinberg School of Medicine, and a physician at Northwestern Memorial Hospital; said that physicians could be giving misleading risk information if they focus only on the next 10 years.

He said that having just one risk factor dramatically increases the chance a patient will develop a major cardiovascular event that could diminish their quality of life or kill them.

The study was part of the Cardiovascular Lifetime Risk Pooling Project, which tracked more than 250,000 participants from 18 different groups of people living in the community over more than 50 years. During the study, the patients' risk factors for cardiovascular disease, including blood pressure, cholesterol levels, smoking status and diabetes status, were measured at ages 45, 55, 65 and 75.

Risk-factor profiles were considered optimal when a participants had a total cholesterol level of less than 180 milligrams per deciliter and untreated blood pressure of less than 120 over less than 80, and did not smoke or have diabetes.

Researchers found that 45-year-old men with risk factors at all optimal levels have a 1.4 percent risk of developing heart disease, or having a heart attack or stroke. Similarly aged men with at least two risk factors had a 49.5 percent chance of having a heart event.

Women who were 45 with optimal risk factors had a 4.1 percent chance of having a heart attack or stroke, while having two or more risk factors increased that risk to 30.7 percent. Women were found to a lower risk of heart attack than men, but a higher lifetime risk of stroke.

Researchers said the study emphasized the importance of lifestyle, and the need for more focus on diet, exercise and smoking cessation.

"Just even one small increase in risk, from all optimal risk factors to one that isn't optimal, like slightly elevated cholesterol or blood pressure, significantly bumps up a person's lifetime risk," Lloyd-Jones said.

"We need to do a much better job of making sure these risk factors don't develop in the first place, getting kids and young adults off to better starts so they don't gain weight and are following healthier lifestyles throughout their lives."

The research was recently published in the New England Journal of Medicine.

Reviewed by: 
Review Date: 
January 24, 2012
Last Updated:
January 25, 2012