(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
