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Nine Controllable Risk Factors

Nine Controllable Risk Factors

Cardiovascular disease is estimated to be the largest cause of death and disability worldwide; 80% of death and disability occurs in low-income and middle-income countries, although the knowledge base of the importance of risk factors is largely derived from developed countries.

Salim Yusuf (McMaster University, Canada) and colleagues did a case-control study of acute myocardial infarction patients in 52 countries, representing every inhabited continent. Around 15,000 cases and 15,000 controls matched for age, sex, and location were enrolled. The relation of smoking, history of hypertension or diabetes, waist to hip ratio, dietary patterns, physical activity, consumption of alcohol, blood lipids, and psychosocial factors to heart attack were analysed and their risk values for heart attack calculated.

The two main risk factors identified from the study were smoking (risk value of 2.9) and raised lipid concentrations (risk value 3.25). Other important risk factors for heart attack were psychosocial factors such as stress (2.7), diabetes (2.4), family history of high blood pressure (1.9), and abdominal obesity (1.1). Three risk factors were protective against heart attack: the daily consumption of fruit and vegetables (0.7), regular physical exercise (0.86), and moderate alcohol consumption (defined as moderate alcohol intake three times a week; 0.91). These associations were found in men and women, old and young, and in all regions of the world.

Professor Yusuf comments: "Although priorities can differ between geographic regions because of variations in prevalence of risk factors and disease and economic circumstances, our results suggest that approaches to prevention of coronary artery disease can be based on similar principles throughout the world.”; Source: Lancet


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