Study indicates nine risk factors explain most heart attacks
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《英国医生杂志》
Nine in 10 heart attacks can be predicted on the basis of nine risk factors, which are the same all over the world irrespective of ethnic group or sex, global research in 52 countries has found.
An abnormal ratio of apolipoprotein A to apolipoprotein B—a more sensitive marker than the ratio of high density to low density lipoprotein—and smoking accounted for two thirds of total risk.
Smoking six to 10 cigarettes a day doubles the risk of heart attack, according to the findings. Smoking 20 cigarettes a day increases the risk fourfold and 40 cigarettes a day gives rise to a ninefold increase in risk.
Other factors included high blood pressure, diabetes, abdominal obesity, low daily fruit and vegetable consumption, a lack of exercise, and stress. However, a small amount of alcohol—around three drinks a week—was moderately protective.
Previous evidence has suggested that only half the risk factors for heart disease can be predicted.
The findings, which were presented ahead of publication in the Lancet at the European Society of Cardiology Congress held in Munich this week, have prompted the authors to call for concerted political action in the arena of food production, tobacco control, and transport policies.
The first such study of its kind, Interheart, included monitoring 15 152 patients after a first heart attack matched with 14 820 people without heart disease for a decade. With the exception of Antarctica, every continent was represented.
The average age of a heart attack was 56 for men and 65 for women, but people in the Middle East, Africa, and South Asia tended to have an attack 10 years younger. And one in 10 of the people in those countries was under the age of 40.
"There are six billion people in the world, five billion of whom are not European, yet most of what we know about heart disease stems from the one billion in rich countries," said Salim Yusuf, professor of medicine at McMaster University, Canada, who led the study.
"Most of the world's population had a lipid level that put them at risk of heart disease," said Professor Yusuf. A person with the complete range of risk factors would increase their chances of a heart attack by 335-fold, said Professor Yusuf.
Together, these factors accounted for 90% of heart attack risk, and were the same the world over. The effects were stronger in younger people, particularly for smoking and abnormal lipid ratio.
"Virtually all risk can be predicted," said Professor Yusuf. "This means that we know most of the causes of heart disease, and we have a lot of information to implement global risk strategies."(Caroline White)
An abnormal ratio of apolipoprotein A to apolipoprotein B—a more sensitive marker than the ratio of high density to low density lipoprotein—and smoking accounted for two thirds of total risk.
Smoking six to 10 cigarettes a day doubles the risk of heart attack, according to the findings. Smoking 20 cigarettes a day increases the risk fourfold and 40 cigarettes a day gives rise to a ninefold increase in risk.
Other factors included high blood pressure, diabetes, abdominal obesity, low daily fruit and vegetable consumption, a lack of exercise, and stress. However, a small amount of alcohol—around three drinks a week—was moderately protective.
Previous evidence has suggested that only half the risk factors for heart disease can be predicted.
The findings, which were presented ahead of publication in the Lancet at the European Society of Cardiology Congress held in Munich this week, have prompted the authors to call for concerted political action in the arena of food production, tobacco control, and transport policies.
The first such study of its kind, Interheart, included monitoring 15 152 patients after a first heart attack matched with 14 820 people without heart disease for a decade. With the exception of Antarctica, every continent was represented.
The average age of a heart attack was 56 for men and 65 for women, but people in the Middle East, Africa, and South Asia tended to have an attack 10 years younger. And one in 10 of the people in those countries was under the age of 40.
"There are six billion people in the world, five billion of whom are not European, yet most of what we know about heart disease stems from the one billion in rich countries," said Salim Yusuf, professor of medicine at McMaster University, Canada, who led the study.
"Most of the world's population had a lipid level that put them at risk of heart disease," said Professor Yusuf. A person with the complete range of risk factors would increase their chances of a heart attack by 335-fold, said Professor Yusuf.
Together, these factors accounted for 90% of heart attack risk, and were the same the world over. The effects were stronger in younger people, particularly for smoking and abnormal lipid ratio.
"Virtually all risk can be predicted," said Professor Yusuf. "This means that we know most of the causes of heart disease, and we have a lot of information to implement global risk strategies."(Caroline White)