Lifetime Risk of Heart Disease Is High ... For Everybody
But the real question is: how many healthy, vigorous years do you want?
Thursday, November 8, 2012
You may be one of those people who eats the most healthful food imaginable, never gets less than eight hours sleep, runs five miles a day, pumps iron religiously and practices yoga to relax each evening.
So you think your risk of developing heart disease is pretty low? No doubt it is -- at least right now. But a new study finds that the lifetime risk of developing heart disease is high for all of us -- greater than 30 percent for the healthiest among us and more than 50 percent for men and women overall.
The distinction is lifetime risk vs. short-term risk. Sure, the couch potato next door may have a higher risk of having a heart attack or other wake-up call over the next 12 months. This study deals with the risk over an entire lifespan.
It's like the statistic you hear frequently quoted that says one in every eight women will develop breast cancer at some point in their lifetime. It's true but can cause one to have an exaggerated fear of developing the disease tomorrow.
The study of cardiovascular disease (CVD) appears in the November 7 issue of JAMA and was released early online to coincide with the American Heart Association’s Scientific Sessions.
No previous data
“To date, there have been no published data on the lifetime risk for total CVD (including coronary heart disease [CHD], atherosclerotic and hemorrhagic stroke, congestive heart failure [CHF], and other CVD death),” according to background information in the article. “Estimates of lifetime risk for total CVD may provide projections of the future population burden of CVD and may assist in clinician-patient risk communication.”
The researchers found that at an index age of 45 years, overall lifetime risk estimates for total CVD through age 95 years were 60.3 percent for men, and 55.6 percent for women. Women had significantly lower lifetime risk estimates than men at all index ages.
Longer survival time free of total CVD was experienced by individuals with optimal risk factor levels when compared with participants with at least 2 major risk factors across all index ages.
“For example, at an index age of 45 years, individuals with optimal risk factor profiles lived up to 14 years longer free of total CVD than individuals with at least 2 risk factors,” the authors write.
The researchers note that “lifetime risks for total CVD were high regardless of index age, indicating that achieving older age free of total CVD does not guarantee escape from remaining lifetime risk for total CVD.” They add that the finding of a substantial lifetime CVD risk even among individuals with an optimal risk factor profile highlights “the large public health burden and opportunities for prevention of total CVD.”
More vigorous years
In other words, a healthful life style may not necessarily buy you more years of life but it may very well buy you a lifetime that includes many more healthy, vigorous years.
The cynics among us are fond of saying that even ultra-marathoners will get old and die. Advocates of risk reduction -- i.e., healthful living -- will answer that, yes, that's true but they will be swimming, running, playing tennis and hoisting grandchildren into the air for 10, 20 or 30 years longer than their peers who contract heart disease, emphysema, diabetes and other chronic diseases in their 40s and 50s.
John T. Wilkins, M.D., M.S., of the Northwestern University Feinberg School of Medicine, Chicago, and colleagues conducted a study to estimate lifetime risk for total CVD in separate models for men and women overall and by aggregate risk factor burden at index ages of 45, 55, 65, and 75 years.
The study consisted of a pooled survival analysis of data from 1964 through 2008 from five National Heart, Lung, and Blood Institute-funded community-based cohorts: Framingham Heart Study, Framingham Offspring Study, Atherosclerosis Risk in Communities Study, Chicago Heart Association Detection Project in Industry Study, and Cardiovascular Health Study.