2 new studies: Most heart attacks caused by unhealthy lifestyle

[slappypan]

Most heart attacks caused by unhealthy lifestyle

Two sweeping studies released today appear to explode the long-held myth that half of heart attacks result from bad genes or bad luck.

The studies, focusing on different populations totaling about half a million people, indicate that about 90% of people with severe heart disease have one or more of four classic risk factors: smoking, diabetes, high cholesterol and high blood pressure.

That means the vast majority of the 650,000 new heart attacks each year could be prevented or delayed for decades by quitting smoking, reducing cholesterol and controlling hypertension and diabetes.

Preventive medicine is many times less expensive than treating disease. Will there be more efforts from employers and healthinsurance companies to coerce people to change their lifestyles, in the name of cost-cutting? How intrusive will these efforts become?

[cprise]

1. Nah

Prevention is for socialist Euro-weenies. Become a cyborg, like Dick Cheney!

[slappypan]

2. that's what I'm afraid of

Cloned heart and liver for Cheney, enforced treadmill time and the Nurse Ratched diet plan for the rest of us.

[sangh0]

3. Propoganda

Two of the four classic risk factors are not determined by lifestyle, blood pressure and cholesterol. For example, I have seriously reduced my intake of animal fats, and cholesterol in general, and I still have high cholesterol. My genetics are such that I could go on a fast, and still have high cholesterol. My body, on it's own, produces too much cholesterol regardless of what I eat.

But if I have a heart attack, it's my own damned fault!

This is just "personal responsibility" propoganda. Not one word about the governments responsibility for health care, nor anything about people's civic responsibility to fund that health care. Nothing about the high cost of drugs that can help reduce the risks, nothing about how pharmacorps profit, and nothing about fast-food corps and their advertising.

[Individualist]

6. Hear, hear

I also have high cholesterol due to genetics. What I eat makes no difference whatever in lowering my cholesterol to acceptable levels.

[zoidberg]

7. But does that mean you can't reduce the other risk factors?

If you naturally have high cholestorol, wouldn't a healthy lifestyle still reduce your chance of getting a heart attack?

[Individualist]

8. What makes you think I don't have a healthy lifestyle?

Makes no difference when one parent's side of the family has a history of generations of heart disease. I've always had a natural preference for low fat foods. My mother, on the other hand, loved fatty foods, gravies, eggs, sausage, etc., etc., ate all she wanted of those type foods, and her cholesterol was low. Did I also mention she smoked all of her adult life??

Also omitted in the report is the fact that a number of diseases elevate the risk of heart disease, among them diabetes and rheumatoid arthritis.

[sangh0]

10. You're missing the point

Of course I would have a lower risk if I eliminated/reduced the other risk factors. However, that's not the same as saying my attack was caused by my lifestyle.

I don't have high BP, I don't have diabetes, and I don't smoke. If I have a heart attack, it's not because of my lifestyle; It's because, like every male in my family, I was born with a body that produces too much cholesterol.

[zoidberg]

12. But that doesn't disprove the premise

That the majority of people can reduce the risk by changing their lifestyle. You are unfortunately in the minority here. Perhaps the study is flawed, but you need to provide evidence that most heart attacks are caused by genetics, not just a single example.

[sangh0]

17. Faulty premise

Not only can "most people" reduce their risk, "*EVERYBODY*" can reduce their risk. However, this article, in addition to it's faults of omission (not mentioning family history and other non-lifestyle related factors) demonstrates it's intention to blame individuals for heart attacks by stating that "most heart attacks are *CAUSED BY* the individuals lifestyle", which is a lot different from saying "people can reduce their risk"

"People can reduce their risk" is:

1) not news
2) of no benefit to those who profit from our health problems.

[stopthegop]

9. blood pressure is frequently

subject to changes in lifestyle...weight, diet, stress...I know from experience...and if you're not responsible for your health, why am I?

[sangh0]

11. a couple of points

1) Not all of the four major factors are subject to changes in lifestyle. Some people cannot change enough to make a significant difference in their BP.

2) They left out a family history of heart disease, which is the case for many who have heart attacks AND HAS NOTHING TO DO WITH LIFESTYLE. Funny how they left that one out! I'm sure it was an unintentional mistake.

3) The point of this article is the propoganda tactic known as "framing the debate". It's a way to limit the discussion to a limited set of facts, all of which support the author's desired conclusion, in order to get people to come to the author's conclusion without the author's explicitely stating the conclusion. This way, people reading the article feel that they came to the conclusion "on their own", and that makes them more likely to believe that conclusion.

[slackmaster]

13. Roger that!

I have hypertension and elevated cholesterol that appear to be hereditary on my father's side. I control both somewhat with diet, exercise, and medication but it's all I can do to keep myself at the high end of normal ranges for all measures.

I don't smoke and never have. The only people in my family who have had major medical problems that led to their deaths were heavy smokers.

The genes I inherited from my mom may carry a propensity to get colon cancer. I had my first colonoscopy two years ago at 43. Next one is due in about a year.

[TAH6988]

16. Somewhat?

How much do you exercise? Are you overweight at all?

[Sperk]

4. except for smoking.... don't the other factors have high

genetic components to them too? My friend/neighbor is in tip top shape, gyn teacher, runner etc. and she's on cholesterol pills. Go figure. :shrug:

[barbaraann]

5. That's why I keep saying universal health care won't work now.

The corporations through various means have gotten most of us living unhealthy lifestyles that even the best medical care cannot correct for entirely. There is probably some mathematical formula that would show that keeping Americans healthy through MEDICAL means rather than a healthy lifestyle would cost more than the entire GDP. Also, the Bush administration is making many people homeless and you simply cannot be healthy and homeless for an extended period of time; and many Americans are afraid to take their much-needed vacations now because they are so worried about keeping their jobs.

Add all of this to increased air pollution and a more degraded environment, genetically modified foods, and far too much sitting in traffic jams because there is no available mass transit.

[diamond14]

14. type I diabetes is NOT caused by lifestyle issues...the cause

is still unknown, but type I diabetes affects children, is the most fatal form of diabetes...totally destroys the ability of the pancreas to produce insulin, and requires multiply daily shots of insulin to survive...most die young....type I diabetes is very fatal and required immediate hospitalization upon onset...there have been some theories that type I diabetes is caused by a virus, a genetic defect, a hereditary disorder, etc...but bush* funds NO research to determine the cause, and has blocked stem-cell research which is the only route to date for possible cure...this childhood form of diabetes (sometimes called 'juvenile' diabetes) is a particular cruel disease affecting millions of children...

it is type II diabetes that is caused by lifestyle...

[Devils Advocate NZ]

15. Too bad they don't explain their methodology in that article...

Because it proves that these studies are misleading. In this article, they don't tell you what percentage of the overall population has one or more of the listed risk factors, and what percentage of the population suffers from heart disease. These two important considerations totally change the meaning of the studies.

For example:

He is co-author of a study involving more than 120,000 heart patients.

Great so 90% of heart patients have one or more risk factor, but what about the general population? If 90% the general population also has one or more of the risk factors (including high cholesterol and high blood pressure, two supposedly VERY common conditions) then this study is absolutely worthless because it merely tells us that heart patients suffer the same problems as non-heart patients.

So I went to the JAMA site to check out the FULL story, and here is what I found:

This study also suggested that, in these large US cohorts, exposure to 1 or more of the major CHD risk factors was also highly prevalent among individuals who did not develop clinical CHD during lengthy periods of follow-up.
http://jama.ama-assn.org/cgi/content/full/290/7/891

So that was one study. It found that the presence of one or more of the listed risk factors was highly prevalent in coronary heart disease sufferers, and that the presence of one or more of the listed risk factors was highly prevalent in non coronary heart disease sufferers. That tells us a lot doesn't it?

The other study never even looked at non-CHD sufferers, and yet it came out with pretty much the same percentage of patients who had one or more risk factor, as the other study found non-sufferers to have.

Here is a table from the more comprehensive study:



Look at the data for men aged 40 to 59. The percentage of men who had one or more risk factor and suffered CHD is listed as in the high 90's whereas the percentage of men who had one or more risk factor and didn't suffer CHD is listed in the mid to low 90's. That seems to suggest an elevated risk, until you notice that the numbers of CHD sufferers are about 1/8 of the non-sufferers.

It seems to me that you could say that 1/8th of the population has a genetically enhanced risk of suffering CHD, and that these risk factors enhance that risk, but that 7/8ths of the population do not have this genetically enhanced risk and thus these other risk factors do not effect them.

In other words, the TRUE meaning of these studies 87.5% of people who have one or more of these risk factors do not develop coronary heart disease.

You see, the studies are right, but only by carefully limiting what they are actually studying: Whether up to 50% of CHD sufferers have one or more of the listed risk factors.

But, just a study of the population tells you that with absolutely NO link between those risk factors and CHD, at least 95% of sufferers would have one or more "risk factor", because 95% of the total population has one or more "risk factor".

In other words, there seems to be NO causal link between the risk factors and CHD. In fact the most that can be said is that for the small percentage of people who are prone to CHD these risk factors make it more likely they will suffer from it.

For the other 80 odd percent of people, these "risk factors" have no meaning.

[sangh0]

18. 2 arms and 2 legs cause heart attacks

Studies show that almost all of the people who have heart attacks have 2 arms and 2 legs.

As I said before, this article uses the propoganda technique known as "framing the issue" whereby facts that contradict the conclusion the propogandist wants you to draw are left out of the article.

Thank you

[slappypan]

19. fascinating post, thank you

Science coverage in the news media is abysmal, even worse than coverage of poilitics, if such a thing is possible. I still wonder if these studies will be used to deny people health coverage or limit them to the cheapest treatment options.