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New research shows that high blood pressure, high cholesterol, diabetes, and smoking account for the vast majority of all deaths caused by cardiovascular disease.

THE FOUR CRITICAL CARDIOVASCULAR DISEASE RISKS THAT YOU CAN CHANGE

As I mention in my recent bestselling book, A Cancer Prevention Guide for the Human Race, many of the very same lifestyle and dietary habits that increase our risk of developing cancer also increase our risk of developing cardiovascular disease, including coronary artery disease, heart attacks (myocardial infarction), peripheral vascular disease, and stroke.  Likewise, adopting an evidence-based cancer prevention lifestyle can not only cut your cancer risk in half, but can also significantly reduce your risk of developing life-threatening cardiovascular disease as well.

A newly published research study, which was funded by the National Institutes of Health, provides, for the first time, a comprehensive assessment of the lifetime risks of developing cardiovascular disease based upon the following four health-related factors: blood pressure, cholesterol (lipid) levels in the blood, smoking status, and diabetes status.  Importantly, this huge meta-analysis study, which appears in the current issue of the New England Journal of Medicine, comprehensively analyzes the data from 18 different prior clinical research studies, which included 257,384 adult black and white men and women.  These research volunteers were assessed for these four critical cardiovascular risk factors every 10 years, beginning at age 45 and ending at age 75.  This enormous group of research volunteers was then closely followed, and the incidence of cardiovascular disease and death rates due to cardiovascular disease were then carefully evaluated and analyzed.

When looking at cardiovascular risks factors at age 55 as predictors of future cardiovascular disease risk, and the risk of death due to cardiovascular disease, the findings of this extremely large clinical study were striking.  In this study, a low-risk profile for cardiovascular disease was defined as total blood cholesterol less than 180 milligrams per deciliter (4.7 mmol per liter), average blood pressure less than 120/80 millimeters of mercury (mm Hg), nonsmoker status, and nondiabetic status.

Among the 55 year-old men and women who met all of the criteria for a low-risk profile for cardiovascular disease, their lifetime incidence of cardiovascular disease, through age 80, was remarkably lower than for the 55 year-olds who failed to meet two or more of the four low-risk criteria.  In fact, the risk of death due to cardiovascular disease, through age 80, was only 5 percent among the men who met all four low-risk criteria at age 55, while the men who met only two or fewer low-risk criteria faced a dramatic six-fold increase in the risk (30 percent) of dying of cardiovascular disease by age 80.  Among the women volunteers, only 6 percent of the women who met all four low-risk criteria went on to die of cardiovascular disease by age 80, while 21 percent of the women who failed to meet two or more of the four low-risk criteria died of cardiovascular disease between age 55 and age 80 (for a nearly four-fold increase in the risk of death).

Fatal and nonfatal coronary artery disease occurred in only 4 percent of the men who met all four low-risk criteria, but occurred in nearly 10 times as many of the men (38 percent) who failed to meet two or more of these four criteria.  The women who met all four low-risk criteria faced a less than 1 percent risk of fatal and nonfatal coronary artery disease, while the women who met two or fewer low-risk criteria experienced an 18 percent incidence of fatal and nonfatal coronary artery disease (for a more than 18-fold increase in risk).

The risk of fatal and nonfatal stroke was also significantly lower among men and women who met all four low-risk criteria for cardiovascular disease.  Among the men who met all four low-risk criteria, the incidence of stroke through age 80 was only about 2 percent, but quadrupled, to more than 8 percent, among the men who failed to meet two or more of the four low-risk criteria.  Among the women who met all four low-risk criteria, the incidence of stroke was about 5 percent, but more than doubled, to nearly 11 percent, among the women who failed to meet at least two of the low-risk criteria.

The findings of this very large study cannot be overstated in terms of its public health importance, as this is the only study that has prospectively assessed very large numbers of men and women, including both black and white adults, over long periods of time, and that has analyzed the long-term impact of the four most common risk factors for cardiovascular disease on incidence and death rates associated with cardiovascular disease.  As with the studies that I discuss in A Cancer Prevention Guide for the Human Race, the impact of lifestyle, diet, and other modifiable health-related factors on both cardiovascular disease risk and cancer risk is enormous, particularly when measured over the lifespan of the average adult.

The findings of this epic public health research study also add further weight to my strong belief, based upon my review of thousands of research studies, that we, as individuals, hold the key to improving our health, and to significantly reducing our risk of serious illness and premature death, by living evidence-based healthy lifestyles.  If your blood pressure is high, change your diet and increase your level of exercise, with the support of your doctor.  If diet and physical activity interventions alone do not correct your hypertension, then ask your doctor about medications for high blood pressure.  If you have diabetes, you also need to change your diet, increase your levels of physical activity, and safely lose any excess weight.  If these lifestyle changes do not completely resolve your high blood sugars, then you may also need to ask your doctor about medications for diabetes.  If you smoke, or use smokeless tobacco, stop immediately.  Finally, if your LDL and total cholesterol levels are high, then, once again, you need to be more careful about what you eat.  (The cancer-preventing foods and diets that I discuss in my book have also been linked to lower levels of blood cholesterol, as well as a much lower risk of cardiovascular disease.)  You may also need to increase your physical activity levels, and get your weight down to a healthy level, to improve your LDL and total cholesterol levels.  Once again, if these prudent lifestyle measures are not enough, by themselves, to bring your cholesterol levels down into the normal range, then your doctor may need to add a cholesterol-lowering medication as well.

The striking results of this important cardiovascular disease prevention study provide all of us with the key to maximally reducing our risk of developing—and dying from—largely preventable cardiovascular diseases, including heart disease and stroke.  Better long-term health (and a longer and more vigorous life) is within your grasp, and this study, in addition to my book, can show you the way forward.

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.com “Top 100 New Book Releases in Cancer” list!

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

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