Most Adult Americans at Some Risk for Heart Disease

MONDAY Sept. 14, 2009 -- Decades of steady progress against heart disease may be on the wane, experts say, with a new study showing that only 7.5 percent of Americans are now in the clear when it comes to heart disease risk factors.

The continuing U.S. obesity epidemic may bear much of the blame for the downturn, the researchers added.

"Our results raise the concern that a worsening cardiovascular risk profile in the population could potentially lead to increases in the incidence and prevalence of cardiovascular disease," said lead researcher Dr. Earl S. Ford, from the U.S. Centers for Disease Control and Prevention. "Potential increases in cardiovascular disease and diabetes could affect the nation's medical costs."

Another expert agreed. Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, called the study "a wake-up call to the entire country to take more responsibility for their health by knowing their own cardiovascular risk factor profile and, in consultation with their physician, to take proactive steps to reduce their cardiovascular risk."

The report is published in the Sept. 14 online edition of Circulation.

For the study, Ford's team collected data on adults 25 to 74 years of age. They specifically looked for low-risk factors for heart disease -- items such as not smoking, having low blood cholesterol, normal blood pressure, normal weight and no sign of diabetes.

Using data from the U.S. National Health and Nutrition Examination Surveys, Ford's group found that in 1971 to 1975, a paltry 4.4 percent of adults had all five of these heart-healthy factors. However, by 1994 that number had risen to 10.5 percent of adults.

But the latest data, from 2004, found that the fraction of American adults with all five healthy characteristics had dropped to 7.5 percent.

Minorities tended to fare worst, since whites tended to have more low-risk factors than either blacks or Mexican-Americans, the report found.

Why the slide back in terms of heart health? Ford cited three reasons: "decreases in the percentages of adults who were not overweight or obese, who had a favorable blood pressure, and who did not have diabetes."

There was one "bright spot," however, a "decrease in the percentage of adults who were not currently smoking," Ford said.

Because excess weight is a major cause of diabetes and hypertension, it is critical that the percentage of adults who are overweight or obese be reduced, the researcher said.

"To effect such change, the efforts of many will be required," he said. "Furthermore, efforts at reducing smoking and improving nutritional practices to lower cholesterol concentrations in the U.S. population should be sustained. Clearly, there is a lot of room for improvement."

Rob M. van Dam, an assistant professor of medicine at Harvard Medical School and author of an accompanying journal editorial, said that "the decline in cardiovascular disease mortality in the U.S. seems to be coming to an end and may even reverse because obesity and obesity-related conditions such as hypertension and type 2 diabetes are on the rise."

"This alarming development is occurring despite great improvements in medical interventions to prevent cardiovascular diseases," he said. "It is of particular concern that these trends do not yet reflect the consequences of the current epidemic of childhood obesity."

Millions of Americans are now beginning their adult lives obese, van Dam noted. That could greatly increase their risk of chronic diseases and premature mortality.

"To fundamentally address this issue, population-wide initiatives are needed to prevent obesity," he said.

Fonarow agreed. "If these trends continue, the recent gains in life expectancy in the U.S. will be lost," he said.

Posted: September 2009


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