BehindTheMedspeak: How To Avoid Heart Attacks

A new study, just published in The Lancet, found that six risky behaviors or medical risk factors account for 90% of all heart attacks worldwide.

The investigators looked at 15,000 heart attack victims and 15,000 controls in 52 countries, representing every inhabited continent.

The same six factors are the culprits for virtually everyone everywhere, regardless of socioeconomic factors.

They are:

•High cholesterol (3.25 x increased risk)

•Smoking (2.87)

•Stress (2.67)

•Diabetes (2.4)

•High blood pressure (1.91)

•Obesity (1.1)

Three things proved to decrease the risk of heart attacks:

•Daily consumption of fruits and vegetables (0.70)

•Regular physical activity (0.86)

•Regular alcohol consumption (0.91)

The abstract of the article is below; if you want to read the whole thing, go to the Lancet website and register (it's free).
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Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study

Salim Yusuf, Steven Hawken, Stephanie Ôunpuu, Tony Dans, Alvaro Avezum, Fernando Lanas, Matthew McQueen, Andrzej Budaj, Prem Pais, John Varigos, Liu Lisheng, on behalf of the INTERHEART Study Investigators

Summary

Background: Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries.

Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown.

Methods

We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent.

15,152 cases and 14,820 controls were enrolled.

The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here.

Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated.

Findings

Smoking (odds ratio 2·87 for current vs never, PAR 35·7% for current and former vs never), raised ApoB/ApoA1 ratio (3·25 for top vs lowest quintile, PAR 49·2% for top four quintiles vs lowest quintile), history of hypertension (1·91, PAR 17·9%), diabetes (2·37, PAR 9·9%), abdominal obesity (1·12 for top vs lowest tertile and 1·62 for middle vs lowest tertile, PAR 20·1% for top two tertiles vs lowest tertile), psychosocial factors (2·67, PAR 32·5%), daily consumption of fruits and vegetables (0·70, PAR 13·7% for lack of daily consumption), regular alcohol consumption (0·91, PAR 6·7%), and regular physical activity (0·86, PAR 12·2%), were all significantly related to acute myocardial infarction (p<0·0001 for all risk factors and p=0·03 for alcohol).

These associations were noted in men and women, old and young, and in all regions of the world.

Collectively, these nine risk factors accounted for 90% of the PAR in men and 94% in women.

Interpretation

Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions.

This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.