By Steve Sternberg, USA TODAY
http://www.usatoday.com/news/
Two sweeping studies out today appear to explode the long-held myth
that half of heart attacks result from bad genes or bad luck.
The studies, focusing on different populations totaling about half a
million people, indicate that roughly 90% of people with severe heart
disease have one or more of four classic risk factors: smoking,
diabetes, high cholesterol and high blood pressure.
That means the vast majority of the 650,000 new heart attacks each
year could be prevented or delayed for decades by quitting smoking,
reducing cholesterol and controlling hypertension and diabetes.
"If we could eliminate smoking and get people to be fit and trim we
could turn this thing around without unraveling the genes that cause
heart disease," says researcher Eric Topol of the Cleveland Clinic
Foundation, co-author of a study involving more than 120,000 heart
patients.
The research has major policy implications. It suggests that doctors
and patients should place even greater emphasis on prevention. The
American Heart Association and National Cholesterol Education Program
both have emphasized aggressively treating people who have not yet
had a heart attack if their "global risk" is high.
"I think these studies will wake people up and renew the emphasis on
traditional risk factors," says Philip Greenland of Northwestern
University, lead author of the study involving almost 400,000 people
enrolled in lifestyle studies and followed for up to 30 years.
The researchers analyzed data from previous major studies. The
reports appear in today's Journal of the American Medical
Association.
"These papers are just amazing. They're basically blowing away the
myth that only half of the people who have heart disease have
traditional risk factors," says John Canto of the University of
Alabama-Birmingham who co-wrote an accompanying editorial in the
journal.
None of the researchers could identify the source of the erroneous
assertion, cited by experts for years. "It's folklore," Greenland
says.
A separate analysis in the journal concludes that there isn't enough
evidence to conclude that so-called new risk factors for heart
disease, including inflammatory proteins called Lipoprotein-A,
C-reactive protein and homocysteine, add much to the predictive value
of the four classic risks.
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