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Heart Disease Risk Factors: More Attention Is Needed

When it comes to caring for your heart, some risk factors can be controlled and others cannot. Of those you can do something about, there are three main risk factors in predicting your odds of developing cardiovascular disease (CVD) or coronary heart disease (CHD). These are the diseases that often end in heart attacks and strokes. They are:

1. Uncontrolled high blood pressure
2. Uncontrolled high levels of low-density cholesterol (LDL - the bad one)
3. Cigarette smoking.

A study of how many of us carry these risk factors and the direction the statistics are taking was recently completed by the National Health and Nutrition Examination Survey. While the news is somewhat encouraging, much more improvement must be made in lowering the number of people who currently have at least one of the three risk factors.
From 1999-2010, the percentage of adults with at least one of the risk factors decreased from 109 million (57.8 percent) to 102.5 million (46.5 percent). But there were some interesting observations and not all of
them positive.
Men and woman were divided into three age groups—20 to 39, 40-59 and 60 and older. Among men, the decrease in risk factors occurred primarily in those between the ages of 40-59 and older than 60. For women, the trend was only found in women older than 60. Having at least one risk factor did not differ between the male age groups and men still are more likely to have at least one risk factor compared with women.
Poverty has a bearing on whether you're at risk for CVD. Over the 12-year study, all income levels saw a decrease in the percentage of their groups with risk factors, but clearly the higher your income, the lower the percentage. At 60.8 percent, lower income adults were more likely to have risk factors compared with middle income earners at 47.2 percent and higher income groups at 37.9 percent. Education level also has a significant impact on cardiac risk. Those with higher education levels have a lower risk than those with less than a high school education.
While we're apparently doing a better job of educating patients on the need to control blood pressure and LDL cholesterol, we may not be doing a great job of persuading patients to take care of possibly the easiest of the three modifiable risk factors—smoking. Over the 12-year period, smoking prevalence remained steady. Among adults older than 20, 25.1 percent were current smokers. High blood pressure dropped 7.6 percent during the time period, while LDL cholesterol declined 9.3 percent.
A National Institutes of Health-supported study of 257,384 people, the first to look at multiple risk factors for CVD across age, sex, race, and generation, found that middle-aged adults who have one or more risk factors for CVD, such as high blood pressure, have a substantially greater chance of having a major heart attack or stroke, during their remaining lifetime than people with optimal levels of risk factors.
While one cannot control family history, age or sex, effort at controlling modifying controllable risk factors, (i.e. high blood pressure, high cholesterol and smoking) can make a major difference not only in your life span, but also your quality of life. Start with making one small change. For most people, exercise is the best medicine available. A daily 30 minute walk can do wonders for your heart health. Over time, it will lower your blood pressure, improve your cholesterol level and may even provide another incentive for smokers to quit.
Dr. Dunker is with the Carondelet Heart Institute at St. Mary’s and can be reached at 816-220-1117.
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