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 For the study, researchers examined the accuracy of results from the
free web-based Healthy Heart Tool (https://healthyheartscore.sph.harvard.edu).
The online survey examines nine lifestyle factors that can influence
the risk of heart disease: smoking, weight, exercise, and
consumption of alcohol, fruits, vegetables, whole grains, nuts,
sugary drinks, and red and processed meat.
It worked “moderately well” at predicting heart disease risk in a
group of almost 5,000 adults who were followed for more than two
decades, starting in their mid-twenties, researchers report in JAMA
Internal Medicine.
“It is not surprising that the factors in the Healthy Heart Score -
diet, exercise, smoking, alcohol and body mass index - predict heart
disease in the future,” said lead study author Dr. Holly Gooding of
Harvard Medical School and Brigham and Women’s Hospital in Boston.
“What is surprising is how well those lifestyle factors measured
before the age of 30 years can predict the risk of heart disease,
even in young adults without other risk factors for heart disease
like hypertension, high cholesterol and diabetes,” Gooding said by
email.
Researchers tested the tool using 25 years of data collected from
the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Participants were 25 years old on average when they joined the
study. Of the 4893 participants, 427, or about 9 percent, had at
least one clinical risk factor for heart disease such as high blood
pressure, elevated cholesterol or diabetes.
Half of the individuals in the study were tracked for nearly three
decades.
During the study, 64 women had a total of 69 heart disease-related
events such as strokes or heart attacks, the study found. This
translates into an annual risk of 0.9 events for every 1,000 women.
Over the same period, 99 men had a total of 104 events, for an
annual risk of 1.75 for every 1,000 men.
At the start of the study, only about one in four people who went on
to have a cardiac event had obvious risk factors like high blood
pressure or diabetes.
But the group that had heart attacks and strokes had the worst
average scores in the Healthy Heart Tool based on their lifestyle
habits at the start of the study.
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One limitation of the study is that with the exception of height and
weight data used to calculate body mass index, all of the other
factors assessed by the online tool were based on self-reported
habits, not data objectively collected by clinicians, the authors
note.
Researchers also assessed habits only once, at the start of the
study, and it’s possible participants changed behaviors in ways that
influenced their odds of a heart attack or stroke.
Even so, offering doctors and patients a way to see heart disease
risk in relatively healthy and young adults may help people make
lifestyle changes while there’s still a chance to significantly
reduce their odds of a heart attack or stroke later in life, said
Dr. John Wilkins, a researcher at Northwestern University Feinberg
School of Medicine in Chicago who wasn’t involved in the study.
The online tool offers feedback that encourages people to take
action to improve poor habits, such as increasing exercise when
activity levels or too low or cutting back on processed meat when
consumption is too high. That feedback might help people take action
early in adulthood when they’re not too set in their ways to change,
Wilkins said in a phone interview.
“It pretty carefully helps you dissect your diet and your level of
physical activity,” Wilkins said.
“Patients and clinicians aren’t particularly good at estimating
their own risk,” Wilkins added. “This is one of the very few
calculators that helps you estimate risk factors early in life, see
how your health behaviors are associated with long-term risk and
what you might change.”
SOURCE: http://bit.ly/2t8QIVG JAMA Internal Medicine, online July
17, 2017.
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