Re: A modifiable 9 Factors account for 90% of total heart disease risk

From: Mark & Steven Bornfeld DDS (bornfeldmung_at_dentaltwins.com)
Date: 08/30/04 

Date: Mon, 30 Aug 2004 17:33:41 -0400

Steve Harris sbharris@ROMAN9.netcom.com wrote:

> Your Heart Disease Risk Is 90% In Your Hands
>
> There's not much you can do about your age or gender. But take comfort
> in the fact that age and gender don't doom you to a heart attack. Some
> people never get heart disease (which is mostly from coronary
> atherosclerosis) no matter how old they get. And age and gender *per
> se* (as broken out from obestity, diabetes, hypertension, etc that go
> along with age *if* you eat wrong), are the cause of less than 10% of
> heart disease risk.
>
> Recently, results from a very large epidemiologic trial (INTER-HEART),
> which follows 27,000 people in 52 countries, has been reported at the
> European Society of Cardiology meeting, which is going on in Munich,
> today.
>
> http://www.cbsnews.com/stories/2004/08/30/health/webmd/main639484.shtml
>
> The results are pretty much the same-old stuff, but they do emphase a
> couple of interesting things. First, is that any genetic factors you
> have that DON'T relate to easily measurable things like diabetes,
> blood pressure, and your cholesterol picture, aren't all that
> important, because they explain only 10% of heart disease. Remember,
> that 10% includes the entire effect of age and gender, too. That means
> it's possible go to your doctor and get a pretty complete risk
> assessment right now. It's not perfect, but we can say it's 90%
> accurate. That's pretty good. It's also pretty neat that no matter how
> hold you get, you can still (probably) modify your life to avoid at
> least 90% of your heart disease risk. If you start young, that is. We
> don't yet know, of course, how late is "too late" for some of these
> things. For example, 30 year-olds get the full ten years of extra life
> if they quit smoking, but it's only 6 years for 50 year olds who quit,
> and 3 years for 60 year olds, etc.
>
> Second, this is the first time I've seen LACK of alcohol intake listed
> as a bona fide cardiac risk factor. It made the top 9! Mormons and
> Seventh-Day Adventists are really going to hate this. Sorry, but red
> wine is here to stay. The French rule, here (now if we could only get
> the French to stop smoking and start bathing).
>
> FYI, the top 9 modifiable heart disease risk factors in INTER-HEART,
> which account for 90% of total heart disease:
>
> 1) Smoking
> 2) Abnormal cholesterol (apo-B/Apo-A1 ratio, which is similar to
> LDL/HDL raio)
> 3) Diabetes
> 4) Hypertension
> 5) Stress
> 6) Abdominal obesity (yow, that gut will get you)
> 7) Sedentary lifestyle
> 8) Eating too few fruits and vegetables
> 9) NO alcohol intake
>
> Read that last one again. The other stuff is the same old grugery, but
> dark chocholate and wine (in moderation) are still mighty fine.
>
> SBH

        Not sure I'm understanding the statistics. You say that genetic
factors NOT related to diabetes, blood pressure, and blood lipid profile
are only responsible for 10% of heart disease. I don't see how this
translates to "you can still (probably) modify your life to avoid at
> least 90% of your heart disease risk. "
        Even if your premise is true that these risk factors are responsible
for 90% of heart disease, your conclusion seems suspect unless you
assume that these factors are 100% controlable.
        Mind you, I'm all for healthy living. I just think there should be
some balance as to how much blame we put on patients for not having
perfect control.

Steve 

-- 
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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