Risks for heart attacks and strokes may be underestimated

According to a new study published in The New England Journal of Medicine by senior author Donald Lloyd-Jones, MD, ScM, FACC, FAHA, both men and women may have a false sense of security about their chances of having a heart attack or stroke. Currently, a patient's risk is calculated for ten years into the future. This new study shows person at short term low risk may be at long-term high risk if he or she has just one or two risk factors, such as high blood pressure or cholesterol.

The study, sponsored by the National Heart, Lung and Blood Institute, is the first to examine the lifetime risk of heart disease in black and white women and men, as most previous studies have been on predominately white males. More than 250,000 participants from 18 groups of people living in the community over more than 50 years. Each patient was assessed for risk factors of cardiovascular disease (such as blood pressure, cholesterol levels, smoking status and diabetes status) at ages 45, 55, 65 and 75 years for each participant.

Some key findings of the study:

• Men who are 45 years old and have all risk factors at optimal levels have a 1.4 percent risk of having a heart attack or stroke or other form of death from heart disease while having two or more risk factors hike the risk to 49.5 percent.

• For 45-year-old women with all risk factors being optimal, the chance of having a heart attack or stroke in their lifetimes is 4.1 percent while having two or more risk factors boost it to 30.7 percent.

• Women have a higher risk than men for a stroke over their lifetimes but a lower risk for a heart attack.

• African-Americans have higher risk factors such as more hypertension and diabetes than whites, but because they also tend to die at younger ages, their lifetime risk of having a heart attack or stroke ends up being the same as whites. 

Dr. Lloyd-Jones is the Chair of the Department of Preventative Medicine and an Associate Professor of Medicine in the Division of Cardiology. He is the Director of the Clinical Trials Unit and Director of the Program in Cardiovascular Risk Estimation, Communication, and Prevention.