Young women with low CVD risk have lower death rate when aged

Young women at low risk for coronary heart disease and cardiovascular diseases have a lower long-term death rate from these diseases and all other causes compared with those with higher risk levels, according to an article in the Oct. 6 issue of The Journal of the American Medicine.

Cardiovascular risk factors include high blood pressure, elevated cholesterol level, high body mass index, diabetes and cigarette smoking.

Studies have shown that young adult men and middle-aged men and women with favorable levels of all major cardiovascular risk factors, that is, low-risk status, have much lower age-specific risks for cardiovascular disease (CVD) and death from all causes than those with adverse levels of one or more risk factors. However, until now, this relationship has not been studied in young women.

Martha L. Daviglus, M.D., professor of preventive medicine, and colleagues at Northwestern University Feinberg School of Medicine examined the relationship between the presence of low levels of risk factors for coronary heart disease (CHD) and CVD in young adulthood and long-term incidence and cause of death in women.

The Chicago Heart Association Detection Project in Industry Study screened approximately 40,000 people 18 years and older from 1967 to 1973. Those at risk for CHD and/or CVD were classified using national guidelines for values of blood pressure, cholesterol, body mass index, diabetes and smoking status.

Of 7,302 women, 20 percent were classified as at low risk for CHD and CVD. In general, women at low risk were younger, white and better educated. A majority of the women (56 percent) had high levels of one or more risk factors. During an average 31 years of follow-up, there were 47 CHD deaths, 94 CVD deaths, and 469 deaths from all causes.

“Our findings show that for young women, a low cardiovascular risk profile is associated with lower long-term CHD, CVD, and all-cause mortality — results in concert with previous findings on young men and middle-aged men and women,” Daviglus and co-authors said.

Findings of the study demonstrate that among persons at low risk earlier in life, CHD and CVD cease to occur at epidemic rates. “These data underscore the importance of a national public priority emphasizing prevention and control of all major CVD risk factors by lifestyle approaches from conception, weaning, childhood, and youth on to increase proportions of the population at low CVD risk,” the researchers said.

Daviglus’s co-researchers on this study were Jeremiah Stamler, M.D., emeritus professor of preventive medicine; Amber Pirzada, M.D.; Lijing L. Yan, research assistant professor of preventive medicine; Daniel B. Garside; Kiang Liu, professor of preventive medicine; Renwei Wang, M.D.; Alan Dyer, professor of preventive medicine; Donald M. Lloyd-Jones, M.D., assistant professor of preventive medicine and medicine; and Philip Greenland, M.D., Harry W. Dingman Professor of Cardiology and chair of preventive medicine, Northwestern University Feinberg School of Medicine.