Elevated risk factors linked to major cardiovascular disease events across a lifetime

January 26, 2012

In one of the largest-ever analyses of lifetime risks for cardiovascular disease (CVD), researchers have found that middle-aged adults who have one or more elevated traditional risk factors for CVD, such as high blood pressure, have a substantially greater chance of having a major CVD event, such as heart attack or stroke, during their remaining lifetime than people with optimal levels of risk factors. This National Institutes of Health-supported study used health data from 257,384 people and was the first to look simultaneously at multiple risk factors for CVD across age, sex, race, and birth generation.

The paper will be published in the January 26 issue of the .

"This paper adds to the substantial body of evidence that modifiable factors in healthy men and women heavily influence the likelihood of developing cardiovascular disease later in life, regardless of their backgrounds," said Susan B. Shurin, M.D., acting director of the NIH's National Heart, Lung, and Blood Institute.

"Prevention of cardiovascular disease is a lifetime opportunity for and a responsibility of individuals, families, communities, and the . This paper reinforces that cardiovascular disease can be prevented and controlled throughout the course of an adult's lifetime," she added.

As part of the Cardiovascular Pooling Project, investigators analyzed 50 years of data from 18 existing cohort, or population-based, studies in the United States. The investigators pooled the data from the 18 cohorts and measured traditional CVD – including , high cholesterol levels, diabetes, and smoking status – in men and women from both black and white populations at ages 45, 55, 65, and 75 years.

Men who were 55 years old with at least two major risk factors were six times as likely to die from CVD by age 80 as were men with none or one CVD risk factor (29.6 percent vs. 4.7 percent). Women with at least two major risk factors were three times as likely to die from CVD as were women with no or one CVD risk factor (20.5 percent vs. 6.4 percent).

When all CVD events – fatal and non-fatal – were considered, the results were even more striking. Forty-five-year-old men with two or more risk factors had a 49.5 percent chance of having a major CVD event through age 80, while 45-year-old women had a 30.7 percent chance. On the other hand, men with optimal risk factor levels only had a 1.4 percent chance of having a major CVD event, while women had a 4.1 percent chance of having a major CVD event through age 80.

The results from each individual study were consistent with one another and with those of the pooled group, and showed that traditional risk factors predicted a person's long-term development of CVD more than age. All of the risk factors appeared to carry the same levels of risk as they did 20, 30, or 40 years ago. While black Americans had a higher prevalence of CVD risk factors than white Americans, their lifetime risks were similar when their risk factor profiles were similar.

"In general, previous studies have only looked at CVD risk factors across one specific age or gender in white populations," said Donald M. Lloyd-Jones, M.D., principal investigator of the study and an associate professor and chair of the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine in Chicago. "We analyzed an enormous pool of available data, which allowed for a more precise estimate of lifetime CVD risks across the age, sex, race, and risk factor spectrum."

Lloyd-Jones added, "These data have important implications for prevention. We need to get more serious about promoting healthy lifestyles in children and young adults, since even mild elevations in risk factors by middle age seem to have profound effects on the remaining lifetime risks for CVD."

The NHLBI supported several of the cohort studies involved, including the Atherosclerosis Risk in Communities Study, Cardiovascular Heart Study, Framingham Heart Study, Framingham Offspring Study, Honolulu Heart Program, Puerto Rico Heart Health Program, and Women's Health Initiative.

"This paper illustrates the power of pooling data from epidemiological studies," said Michael Lauer, M.D., director of the NHLBI's Division of Cardiovascular Sciences. "Because of the U.S. government's investments in these studies, it was possible for the investigators to gather and analyze data on over a quarter of a million people, which could lead to substantial public health and clinical practice implications."

"It is important for adults to know their blood pressure and cholesterol numbers and whether they are at risk for diabetes and also to understand the different approaches they can take to prevent or control their risks for CVD. As American Heart Month approaches in February, this paper underscores the importance of raising awareness of heart disease and coronary heart disease – the most common type of heart disease and the number one killer of both men and women in the United States," said Lloyd-Jones and Shurin.

In an effort to help people reduce their risks of cardiovascular disease, the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services recently launched the Million Hearts Campaign, a national initiative to prevent 1 million heart attacks and strokes over the next five years.

Also, in December 2010, in an effort to promote healthy behaviors and prevent diseases, including , the U.S. Department of Health and Human Services launched Healthy People 2020. Healthy People 2020 and its specific, measurable health objectives represent the nation's disease prevention and health promotion goals for the coming decade.

Explore further: Middle-age blood pressure changes affect lifetime heart disease, stroke risk

Related Stories

Middle-age blood pressure changes affect lifetime heart disease, stroke risk

December 19, 2011
An increase or decrease in your blood pressure during middle age can significantly impact your lifetime risk for cardiovascular disease (CVD), according to research in Circulation: Journal of the American Heart Association.

Middle-age risk factors drive greater lifetime risk for heart disease

January 25, 2012
A new study in today's New England Journal of Medicine reports that while an individual's risk of heart disease may be low in the next five or 10 years, the lifetime risk could still be very high, findings that could have ...

Will you have a heart attack or stroke?

January 25, 2012
Will you have a heart attack or a stroke in your lifetime? Your odds may be worse than you think.

Recommended for you

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

'Fat but fit' are at increased risk of heart disease

August 14, 2017
Carrying extra weight could raise your risk of heart attack by more than a quarter, even if you are otherwise healthy.

Air pollution linked to cardiovascular disease; air purifiers may lessen impact

August 14, 2017
Exposure to high levels of air pollution increased stress hormone levels and negative metabolic changes in otherwise healthy, young adults in a recent study conducted in China. Air purifiers appeared to lessen the negative ...

Study hints at experimental therapy for heart fibrosis

August 14, 2017
Researchers report encouraging preclinical results as they pursue elusive therapeutic strategies to repair scarred and poorly functioning heart tissues after cardiac injury—describing an experimental molecular treatment ...

Scientists identify mutations in venous valve disease

August 14, 2017
A team of scientists has discovered that mutations in the genes FOXC2 and GJC2 are associated with defects in venous valves, flaps within veins that help maintain proper blood flow.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.