Interheart report: Nine easily measurable factors can predict more than 90 per cent of people at risk of heart attack, a global study has shown.
The Interheart study of over 29,000 people in 52 countries found that the most important risk factors for heart attack are smoking and high cholesterol.Together, they predicted two-thirds of the global risk of heart attack. Additional risk factors identified by the research were: high blood pressure, diabetes, abdominal obesity and stress. Daily consumption of fruit and vegetables and daily exercise, along with a small alcohol intake, were found to protect against heart attack.
The results of the study were presented at the European Society of Cardiology (ESC) conference in Munich, Germany by Dr Salim Yussuf, professor of medicine and director of the Population Health Research Institute at McMaster University, Hamilton, Ontario. It will be formally published in the Lancet on September 11th.
"These risk factors appear to predict the majority of the risk in virtually every region, every ethnic group, in men and women and in the old and young," Dr Yussuf said.
"Since these factors may all be modified, this... will change the way we look at heart attack prevention. It means we should be able to prevent the majority of premature heart attacks in the world."
Interheart is the first examination of the impact of risk factors for heart attack in all major ethnic groups. The study looked at 7,000 Europeans, 6,000 Chinese, 6,000 Asians as well as smaller groups of Africans, Arabs and Canadians.
Commenting on the study, Dr Alan Bernstein, president of the Canadian Institute of Health Research, said it suggested that a combination of lifestyle changes could lead to an 80 per cent reduction in the risk of heart attack.
Dr Vincent Maher, medical director of the Irish Heart Foundation, while welcoming the study, said he was surprised that a family history of heart disease was not identified as a risk factor.
"The question that must be asked about these modifiable risk factors is what are we doing about them. How early do we intervene, for example, with the person with central obesity?" he said.
A separate study on the diabetic state of patients with established coronary heart disease, also presented at the ESC conference, found that up to 22 per cent of heart disease patients had newly detected diabetes.
The Euroheart survey of 4,200 patients in 25 countries also found that prognosis, measured by death or non-fatal heart attack, of heart disease patients was worse for those who also had diabetes.
Patients with both heart disease and diabetes were less well managed than those with coronary heart disease alone, the study found. Such patients were less likely to have undergone coronary artery bypass surgery and coronary angioplasty (the insertion of a balloon to compress a blockage in the artery).
Prof Lars Ryden, of the Karolinska University Hospital. Solna, Sweden, the principal study investigator, told a press conference there was a need for "evidence-based treatment, in particular, coronary interventions, to be improved in diabetic patients with coronary artery disease."
Meanwhile, Greek research presented at yesterday's conference suggests people with asthma, who also have coronary artery disease, should use inhalers containing the drug, Salbutamol, with caution. The small study of 12 patients found that after a second inhalation of the drug, designed to open the airways wider during an acute asthmatic attack, the demand for oxygen by the heart increased disproportionately.