Having 1 or More of 4 Risk Factors Increases Risk of Coronary Death 95%
posted 11/18/03
Two analyses now show that 80%-90% of CHD patients—and 95% of those with fatal CHD events—have at least one of four major risk factors (smoking, hypertension, high cholesterol, or diabetes).

Dr. Philip Greenland of Northwestern University, Chicago, and his associates reviewed three prospective cohort studies involving nearly 387,000 subjects. At least one of the four risk factors was present in 87%-100% of subjects who developed CHD. The results were consistent across a broad age range, in all races, and in both genders (JAMA 290[7]:891-97, 2003).

Dr. Umesh N. Khot of the Cleveland Clinic Foundation and his associates reviewed data from 14 randomized clinical trials. Only 10%-15% of CHD patients aged 55 and older lacked all four major risk factors. Again the results were consistent despite differences in subjects' gender, age, race, and geographic region. “In essence, patients without conventional risk factors are unlikely to develop CHD,” they said (JAMA 290[7]:898-904, 2003).

The studies, which review findings on over half a million CHD patients, effectively debunk the myth that half of coronary disease strikes out of a clear blue sky, and the findings are likely to have “enormous” public health implications, Dr. John G. Canto and Dr. Ami E. Iskandrian said in an editorial (JAMA 290[7]:947-49, 2003). “Remarkably, these findings perhaps underestimate the true extent of this phenomenon, especially given the self-report design of [some of the reviewed studies] and the fact that a number of patients were likely unaware of or not diagnosed as having risk factors at the time of evaluation.”

Source: Diabetes In Control.com.

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