Heart attacks - 9 factors ( ext)

Over 90 percent of heart attacks worldwide can be predicted by nine risk factors, a landmark study has found

The study has overturned the common perception that only half of the risk of heart attacks can be accounted for.

The implications are straightforward: if we implement what we know today, we should be able to avert the majority of premature heart disease cases.

Study of acute myocardial infarction (AMI) in 52 countries representing every inhabited continent and enrolled 15, 152 individuals with their first heart attack and 14,820 controls adjusted for age, sex and region. In terms of ethnicity, about a quarter of the participants were European and a quarter Chinese.
The top two risk factors were abnormal lipids (the ratio of apolipoprotein B to apolipoprotein A1) and smoking.

Together, they accounted for two-third of the population attributable risk (PAR) of AMI. Both these factors also showed a graded dose-response relationship with the odds of an AMI.

The other risk factors were psychosocial factors, hypertension, diabetes and abdominal obesity. Eating fruits and vegetables, regular alcohol consumption in small amounts and physical activity were protective against AMI. One of the surprises of the study was how important psychosocial factors were, psychosocial factors were found to increase the risk of a heart attack about two and a half times.
Also noted that abdominal obesity was an important risk factor - even greater than the risk associated with smoking.

Western Europe, North America, Australia and New Zealand, and Southeast Asia. However, in countries such as China where obesity is less prevalent, the risk from obesity was far less than that associated with smoking.

The median age of first AMI in men was 9 years younger than in women. Men and women had similar odd ratio for the risk factors of smoking, raised lipids, abdominal obesity, psychosocial factors and fruit and vegetable on consumption

However the increased risk associated with diabetes and hypertension and the protective effect of exercise and alcohol, were greater in women than men.

Comparing the effects of these risk factors among the young (=55 years for men, =65 year for women) and the old, the nine risk factors accounted for a significantly greater PAR in the former.
The study findings underline the message that a healthy life style matter.

Globally, about 55 to 60 percent of the PAR can be attributed to an adverse lifestyle. And this is consistent in every region of the world, and obviously, tobacco is the biggest culprit.

The study found that eating fruits and vegetables, taking exercise and avoiding smoking could lower the risk of a heart attack by about 80 percent. These results are similar to that of the US Nurses Health Study, which found that lifestyle modification could potentially avoid more than three-quarters of the risks of coronary heart disease and strokes in women.

The risk factors of AMI are strikingly consistent across age genders, ethnicity and region.