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Your lifetime risk of cardiac death may be set by middle age

Two or more risk factors by age 55 can be a killer

Topics: Cardiovascular, Service Lines, Screening and Prevention, Methodologies, Performance Improvement

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January 27, 2012

Having just two major risk factors for cardiovascular disease—such as hypertension, high cholesterol, diabetes, and smoking—at age 55 may predict a high lifetime risk of cardiac death, according to a recent NEJM study.

The study notes that risk assessment tools, such as the Framingham prediction tool, can typically only assess for short-term risk. However, "the majority of adults in the U.S. who are considered to be at low risk for cardiovascular disease in the short term are actually at high risk across their remaining lifespan."

For the study, Northwestern University researchers' Cardiovascular Lifetime Risk Pooling Project compiled data from 18 longitudinal studies from the past 50 years on 257,384 men and women. The study found that only 5% of study participants had an optimal cardiovascular risk factor profile with cholesterol and blood pressure within the recommended levels, and no smoking or diabetes. About 40% had one major risk factor and another 25% had two or more of the major risk factors.

Related: Your blood type may predict survival in heart surgery

Men with two or more major risk factors at age 55 had a 37.5% lifetime risk of fatal coronary heart disease or myocardial infarction compared to a risk of 3.6% in those with an optimal risk-factor profile. Women with two or more major risk factors at that age faced an 18.3% lifetime risk of those events compared to 1% for those with an optimal profile. Fatal or nonfatal stroke risk was also lower for those with an optimal profile than those with two or more risk factors.

The findings did not indicate that black individuals were more likely to die from cardiovascular events than white individuals, leading the researchers to conclude that the "presence or absence" of these risk factors "appears to represent a much more consistent determinant of the long-term risk of cardiovascular disease than race or birth cohort."

The study authors say the findings show that efforts to prevent cardiovascular disease should focus on preventing the development of risk factors, rather than treating existing risk factors (Phend, MedPage Today, 1/25).

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