CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

January 25th, 2012

Huge Study Finds Risk Factors Do In Fact Predict Risk

An enormous new meta-analysis confirms the important role that risk factors play over a lifetime in the development of cardiovascular disease. In a paper published in the New England Journal of Medicine, Jarett Berry and colleagues report on the meta-analysis from the Cardiovascular Lifetime Risk Pooling Project, which contains data from 18 epidemiological studies including more than one-quarter million people whose risk factors — blood pressure, cholesterol level, smoking status, and diabetes status — were measured every decade from 45 to 75 years of age.

At age 55, compared to people with two or more risk factors, people with an optimal risk factor profile had a greatly reduced risk of death from CV disease  or CHD through the age of 80:

Death from CV disease (two or more risk factors vs. optimal risk factor profile):

  • men: 29.6% vs. 4.7%
  • women: 20.5% vs. 6.4%
Fatal CHD or nonfatal MI:
  • men: 37.5% vs. 3.6%
  • women: 18.3% vs. <1%

Fatal or nonfatal stroke:

  • men: 8.3% vs. 2.3%
  • women: 10.7% vs. 5.3%

“In general, previous studies have only looked at CVD risk factors across one specific age or gender in white populations,” said Donald M. Lloyd-Jones, principal investigator of the study, in an NHLBI press release. “We analyzed an enormous pool of available data, which allowed for a more precise estimate of lifetime CVD risks across the age, sex, race, and risk factor spectrum.”

The authors identified three major findings in their study:

  1. The results “strongly reinforce the influence of traditional risk factors on the lifetime risk of cardiovascular disease. Even a relatively low burden of these risk factors was associated with significant increases in the long-term risk of cardiovascular disease, and the absence of traditional risk factors was associated with a very low lifetime risk.”
  2. The impact of the risk factors “remained remarkably consistent across birth cohorts.”
  3. Risk factors had the same influence on lifetime risk in blacks and whites.

Categories: General, Prevention
Tags: ,


You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

2 Responses to “Huge Study Finds Risk Factors Do In Fact Predict Risk”

  1. Carlos A Selmonosky, MD, MD says:
    February 6, 2012 at 11:04 pm

    Is there a study relating risk factors to the diagnosis of coronary pain versus non coronary pain?.

    Competing interests pertaining specifically to this post, comment, or both:
    None

  2. William L Blanchet, MD says:
    February 7, 2012 at 9:47 pm

    What this study shows is that if you have optimal risk factors, you still have a greater risk of dying from vascular disease than you have of dying from colon cancer.

    A 3% risk of dying from colon cancer mandates colonoscopy every 10 years after age 50. Colonoscopy is an expensive and invasive test with significant potential for complications.

    This study demonstrates a 4.7% risk of death in men and a 6.4% risk of death in women from vascular disease when risk factors are “optimal”. I fail to see why a coronary calcium score should not be performed on even this subset of patients as a calcium score is inexpensive, essentially without complications, and is very accurate at finding out which of these “optimal” subjects are really at risk, are and direct them toward therapy.

    I fear that this is yet another study where the author’s conclusions reflect what he is looking for rather than what he is looking at.

    Competing interests pertaining specifically to this post, comment, or both:
    I use EBT coronary calcium imaging to detect coronary risk and serial imaging to document adequacy of treatment. I saw no heart attacks in 2010 or 2011 despite having an internal medicine practice of mostly older subjects, many with significant coronary risk factors.