A study published in the February 14, 2006 issue of Circulation reported the association between the presence of cardiovascular disease risk factors at age 50 and the risk of developing cardiovascular disease over the next 45 years. The study also calculated the association between cardiovascular disease risk factors and survival.

Donald M. Lloyd-Jones, MD, of Northwestern University in Chicago and colleagues followed 3,564 men and 4,362 women who participated in the Framingham Heart Study. Participants who were free of cardiovascular disease before their initial examination between 1971 and 2002 were included in the current analysis. Cardiovascular events occurred in 1,757 participants during the follow up period ending in 2002, and noncardiovascular deaths occurred in 1,641. Lifetime cardiovascular disease risk for men and women at age 50 were calculated as 51.7 and 39.2 percent.

Optimal risk factors were defined as a cholesterol level of 180 milligrams per deciliter or lower, blood pressure less than 120/80 mm Hg, being a nonsmoker, and being nondiabetic. Having a cholesterol level of 240 milligrams per deciliter or more, blood pressure 160/100 mm Hg or higher, being a smoker, and being diabetic were considered to be major risk factors. Men with optimal risk factors had a 5.2 percent risk of developing cardiovascular disease while those with two or more major risk factors experienced a 68.9 percent risk . For women with optimal risk factors, the risk was 8.2 percent, in contrast with a 50.2 percent risk incurred by those with at least two major risk factors. Survival among men and women with optimal risk factors at age 50 was 39 years, compared to 28 years for men and 31 years for women with two or more major risk factors.

Prior to this study, lifetime risk for cardiovascular disease had not been estimated. The additional years of life associated with having optimal risk factors at age 50 should encourage younger people to achieve them.

—D Dye