Modest lifestyle changes almost eliminate CVD risk

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Modest lifestyle changes almost eliminate CVD risk

Combining modestly lower LDL cholesterol (LDL-C) and systolic blood pressure (SBP) can reduce the lifetime risk of cardiovascular disease by almost 90 per cent, according to new findings reported at ESC Congress 2016 in Rome.

The results “demonstrate for the first time that LDL cholesterol and SBP have independent, multiplicative and cumulative causal effects on the risk of cardiovascular disease,” says lead investigator Brian Ference, from Wayne State University School of Medicine, Detroit. “This suggests that a simple strategy that encourages long-term exposure to the combined reduction of both 1mmol/L in LDL-C and 10mmHg SBP has the potential to largely eliminate the lifetime risk of cardiovascular disease – with a reduction of up to 90 per cent.”

The study analysed genetic and cardiovascular risk factor data for 102,773 people from 14 studies. The researchers divided participants into four groups:
• Reference
• LDL-C genetic score below the median, which results in lower LDL-C
• SBP genetic score below the median (lower SBP)
• LDL-C and SBP genetic scores below the median.

There were 14,368 primary outcome events: first occurrence of coronary death, non-fatal myocardial infarction, non-fatal stroke or coronary revascularisation. Compared to the reference group, subjects in the lower LDL-C group had 54.2 per cent lower risk of the primary outcome. Those in the lower SBP group had 44.7 per cent lower risk and those in the combined lower LDL-C and SBP group had 86.1 per cent lower risk.

“The results of our study confirm that cardiovascular disease is largely preventable and suggest that this prevention can be substantially simplified by focusing on programmes that promote long-term exposure to the combination of both lower LDL-C and lower SBP,” concludes Dr Ference. Further studies are needed to identify patients who might benefit most.

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