Heart Disease Risk on the Rise
Reported September 17, 2009
(Ivanhoe Newswire) — After two decades of improvement, the percentage of Americans with major heart disease risk factors is once again on the rise, according to a new report.
People with lower risk factors have lower healthcare costs and are far less likely to develop cardiovascular disease.
“From a preventive health point of view, it’s important that individuals achieve as many of these goals as possible, and it’s disappointing that less than 10 percent of Americans are meeting them at all,” Earl S. Ford, M.D., M.P.H., lead author of the study and medical officer of the U.S. Public Health Services at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, was quoted as saying.
Dr. Ford went on to say, “Our analysis suggests that achieving low risk status for most U.S. adults remains a distant and challenging goal. Unfortunately, the limited strides that were made toward this goal during the 1970s and 1980s were eroded by the increases in excess weight, diabetes and hypertension during more recent decades.”
Researchers tracked data on adults aged 25-74 in four national surveys, examining the following low-risk criteria:
Never or former smoker
Total cholesterol below 200 and not using cholesterol-lowering drugs
Blood pressure below 120/80 without using blood pressure-lowering medication
Not overweight or obese, as reflected in a body mass index (BMI) less than 25
Never diagnosed with diabetes.
The National Health and Nutrition Examination Surveys (NHANES) showed that in 1971 1975, 4.4 percent of adults had all five low-risk factors. From 1976 1980, 5.7 percent had all five, and in 1988 to 1994, that figure rose to 10.5 percent of adults. But, in the 1999 2004 survey, only 7.5 percent of adults rated low risk.
“Until the early 1990s, we were moving in a positive direction, but then it took a turn and we’re headed in a negative direction,” Ford said. “When you look at the individual factors, tobacco use is still headed in the right direction and so are cholesterol levels, although that has leveled off. The problem is that blood pressure, BMI and diabetes are all headed in the wrong direction.”
An imbalance in the amount of energy consumed in food and the amount expended in physical activity is likely a major culprit in the negative risk factor trends, Ford said. “Addressing this imbalance, by people becoming more active and eating less, would reduce overweight and obesity which in turn would help to lower blood pressure and prevent diabetes.”
Results of the study illustrate the need for prevention. “Thus, healthcare providers should have adequate resources, time and reimbursement to engage in the prevention of cardiovascular disease in patients,” researchers are quoted as saying. “Such efforts by clinicians need to be complemented by efforts by state and national agencies that have the responsibility to develop effective public health interventions.”
Potential targets for such interventions include work sites and schools where large numbers of people can be targeted and where evidence-based interventions can be implemented.
In an accompanying editorial, Rob M. van Dam, Ph.D. and Walter C. Willett, M.D., Ph.D. of Harvard Medical School and Brigham and Women’s Hospital are quoted as saying the findings are disturbing because the trends do not yet reflect the effects of the current epidemic of childhood obesity. “Much potential exists to reverse ominous trends in cardiovascular risk factors and mortality in the United States, but this is unlikely to occur without making prevention of overweight and obesity a clear national priority.”
SOURCE: Circulation: Journal of the American Heart Association, September 14, 2009