It Turns Out That Most Cases Of Heart Disease Could Have Been Predicted
A new study suggests that the “silent killer” should have been predictable.
Most of us know someone who died suddenly or unexpectedly from heart disease. It is an all too familiar story that goes something like this: “Did you hear Frank dropped dead at work today? He had no symptoms or history of heart trouble.” A new study suggests this is not entirely true.
The study did not look specifically at sudden unexpected cardiac death. However, it looked at suboptimal levels of four traditional risk factors for CVD (cardiovascular disease): blood pressure (BP), cholesterol, glucose, and tobacco smoking before the first diagnosis of coronary heart disease (CHD or blocked arteries, heart failure (HF), or stroke. The population studies were conducted in Korea and among multiple ethnic groups in the USA.
At least one of these traditional risk factors was suboptimally treated before the diagnosis of those three things. Suboptimal treatment was defined as BP higher than 120/80 or on BP meds, total cholesterol blood levels of >200, or taking lipid-lowering medications, fasting blood sugar> 100, or a diagnosis of diabetes, and past or current tobacco use. One more suboptimally treated risk factors correlate highly with CHD, HF, or stroke.
Less strict criteria for suboptimal treatment of these risk factors were examined and showed similarly strong results.
These results not only challenge claims that CHD events frequently occur without antecedent major risk factors but also demonstrate that other CVD events, including HF or stroke, rarely occur in the absence of nonoptimal traditional risk factors, highlighting the importance of primordial prevention efforts.
This binational study showed that >99% of people who developed CHD, HF, or stroke had one or more suboptimally treated risk factors before the disease event. The findings were consistent across all age groups and sexes.
The conclusion was that CVD events rarely occur in the absence of these antecedent traditional risk factors. The study has some limitations. It is possible that Frank, in our first example, died without risk factors, but never saw a doctor to be diagnosed. When it comes to CVD, “what you don’t know can kill you.”
The bottom line is that all adults should be screened at least annually for these traditional risk factors, and if present, attempts should be made to get these levels to optimal levels.
I am a retired MD passionate about health, medicine, gardening, culture, and food.
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