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Middle-Age Heart Risk Factors Shorten Men's Lives

Smoking, hypertension, high cholesterol cut 10 years of life, study finds,,

THURSDAY, Sept. 17 (HealthDay News) -- Middle-aged men with risk factors for heart disease such as smoking, high blood pressure and high cholesterol are taking 10 to 15 years off their lives compared to men without these troubles, British researchers say.

Although death from heart disease has been declining, in part due to better control of cardiovascular risk factors and better care, this is the first study that looks at death from heart disease in terms of life expectancy, the researchers said.

"The good news is that all of us can make changes to live a healthy life," said lead researcher Dr. Robert Clarke, a reader in epidemiology at University of Oxford. "Those changes, we now know, can translate into a 10- to 15-year difference in life expectancy."

Although not the subject of this study, Clarke suspects the same lessons would apply to women.

The report is published in the Sept. 18 online edition of the British Medical Journal.

For the study, a team led by Clarke, a reader in epidemiology at the University of Oxford, collected data on nearly 19,000 men ranging from 49 to 69 years of age. The men all participated in what's known as the Whitehall Study and were first evaluated between 1967-1970.

At the start of the study, the men completed a questionnaire that included questions about their medical history, smoking, employment and marital status. In addition, height, weight, blood pressure, lung function, cholesterol and blood sugar levels were also measured.

After about 28 years of follow-up, 7,044 surviving men were examined again in 1997.

When the study began, 42 percent of the men smoked, 39 percent had high blood pressure and 51 percent had high cholesterol. By 1997, about two-thirds had stopped smoking and their blood pressure and cholesterol levels had also dropped, the researchers noted.

Despite these changes in risk factors for heart disease, men who had three heart risk factors in middle age had a threefold higher risk of dying from heart disease and a twofold increased risk of dying from other causes, compared with men with none of these risk factors, Clarke's team found.

In fact, men who had all three risk factors at the time they entered the study lived 10 years less than men with none of the risk factors. Life expectancy after 50 was an additional 23.7 years for men with three risk factors, compared with 33.3 years for men without the risk factors, the researchers found.

When Clarke's group evaluated the men using a risk score that took into account smoking, diabetes, employment, blood pressure, cholesterol and body-mass index. Men in the highest (worst) five percent of this risk score cut their life expediency by 15 years from age 50, compared with men with the lowest risk score (20.2 vs. 35.4 years).

"Cardiovascular risk factors are well-documented to result in premature cardiovascular events and cardiovascular deaths," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles. "This study quantifies how the presence or absence of certain cardiovascular risk factors in middle age influences life span."

Three modifiable risk factors -- smoking, high blood pressure and high cholesterol -- seemed most dangerous, Fonarow noted.

"Individuals who choose to not treat and control these major cardiovascular risk factors should recognize they may be giving up, on average, as much as 10 to 15 years of life by doing so," he said. "More needs to be done to identify, treat and control major cardiovascular risk factors to reduce the global burden of cardiovascular events and premature cardiovascular deaths."

While this study was conducted in England, the problem is equally prevalent in the United States.

For example, a recent study in the Sept. 14 online edition of Circulation found that after decades of steady progress against heart disease, the illness appears poised for a comeback. The study found that only 7.5 percent of Americans are now in the clear when it comes to heart disease risk factors.

The continuing U.S. obesity epidemic may bear much of the blame for the downturn, the researchers said.

"Our results raise the concern that a worsening cardiovascular risk profile in the population could potentially lead to increases in the incidence and prevalence of cardiovascular disease," said lead researcher Dr. Earl S. Ford, from the U.S. Centers for Disease Control and Prevention. "Potential increases in cardiovascular disease and diabetes could affect the nation's medical costs."

More information

For more information on heart disease, visit the American Heart Association.

SOURCES: Robert Clarke, M.D., reader in epidemiology, University of Oxford, UK; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Sept. 18, 2009, British Medical Journal

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