Will you have a heart attack or stroke?

January 25, 2012

CHICAGO --- Will you have a heart attack or a stroke in your lifetime? Your odds may be worse than you think.

Men and women may have a false sense of security about their chances of having a heart attack or stroke based on the current practice of calculating a patient's risk 10 years into the future. New Northwestern Medicine research shows a young or middle-aged adult who is at low risk in the short term may be at very high risk in the long term -- if he or she has just one or two risk factors such as higher than optimal cholesterol or blood pressure levels.

This is the first study to examine the lifetime risk of heart disease in white and black men and women. Previous studies have been in whites and predominantly males. It's also the first study to look at the entire adult age spectrum. The research also looked at the risk across multiple birth cohorts and found the effect of the risk factors remained consistent regardless of the decade in which a person was born.

The study is published in the New England Journal of Medicine. Part of the Cardiovascular Lifetime Risk Pooling Project, the research tracks more than 250,000 participants from 18 different groups of people living in the community over a period of more than 50 years. The patients' risk factors for cardiovascular disease -- blood pressure, cholesterol levels, smoking status and diabetes status -- were measured at ages 45, 55, 65 and 75 years for each participant.

"We are giving incomplete and misleading risk information if we only focus on the next 10 years of someone's life," said principal investigator Donald Lloyd-Jones, MD, chair and associate professor of preventive medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "With even just one risk factor, the likelihood is very large that someone will develop a major cardiovascular event that will kill them or substantially diminish their quality of life or health."

The risk-factor profile was considered optimal when a participant had a total cholesterol level of less than 180 milligrams per deciliter and untreated blood pressure of less than 120 over less than 80, was a nonsmoker and did not have diabetes.

The new research on long-term risk may be important in estimating the future burden of cardiovascular disease in the general population, Lloyd-Jones noted.

Some key findings of the study: "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. (Non-optimal means a person doesn't have diabetes and doesn't smoke but either cholesterol is 180 to 199 or blood pressure is 120 to 130 on top or 80 to 89 on the bottom. These numbers aren't at levels that need to be treated with medication, but they are still higher than desired.) "This study underscores the importance of lifestyle -- particularly diet, exercise and smoking cessation -- all the lifestyle patterns that are important in reducing the development of the risk factors in the first place," said Jarett Berry, MD, who worked on the study when he was at Northwestern's Feinberg School and is now assistant professor of medicine at University of Texas Southwestern Medical Center.

"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," Lloyd-Jones said.

Lloyd-Jones pointed out that maintaining the full package of optimal risk factors through middle age had a dramatic effect on the remainder of a person's life. "It appears that the whole is greater than the sum of the parts," he said.

Northwestern University

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.