1. Intro

Question 1

According to Interheart study, what are the 5 risk factors that contribute to a large proportion of population attributable risk of AMI? What is that %?

Which risk factors account for 90% of population attributable risk in men? What is that % for women?

Ch1H

Answer 1

5 factors
- smoking
- lipids
- BP
- DM
- obesity
(80%)

9 factors accounting for 90% men, 94% women

• above 5 and
• diet
• physical inactivity
• alcohol
• psychosocial factors

Question 2

According to the Interheart Study, what are examples of psychosocial risk factors?
What were they comparable to?
what is the population attributable risk?

Answer 2

• stress
• mental illness
• isolation
• addiction

comparable to HT, abdominal obesity (PAR 33%)

Question 3

In the InterSTROKE study, what were the 10 risk factors identified for strokes?
What % risk was associated with these RF?

Answer 3

• smoking
• lipids
• BP
• DM
• obesity
• diet
• physical inactivity
• alcohol
• psychosocial factors
• depression
• “cardiac causes”??

These factors associated with 90% risk of stroke in men/women all ages

Question 4

Which study showed an association between people who were lower risk in middle age (fewer RF present at that life stage) with a better QoL at older ages and with lower Medicare costs?
What fraction of the total charges did men/women have?

Answer 4

Chicago Heart Association Detection Project in Industry results
Men at low risk had <2/3 total charges ($1615 less than control population)
Women at low risk had <1/2 total charges ($1885 less)

Question 5

Which 6 lifestyle changes can reduce a person’s risk of heart disease by as much as 90-95%? According to the Chicago Heart Association Detection Project in Industry

Answer 5

(brackets for % reduction in risk of heart disease)

• 50% decrease in Total cholesterol (50%)
• 6 mm decrease in DBP (16% reduction in risk of heart disease, 42% reduction in stroke risk)
• stop smoking (50% risk sudden MI)
• maintain ideal body weight and waist size (35-55%)
• > 150min/week of moderate exercise (35-55%)
• > 5 serves fruit & veg/d (20-25%)

Question 6

Comparison of lifetime risk profiles for men and for women regarding atherosclerotic CVD, according to Framingham Heart Study?
Life expectancy?

Answer 6

At age 50,

• Men with optimal risk status vs 2 or more RF had 5% vs 69% lifetime risk of ASCVD
• Women with optimal risk stats vs 2 or more RF had 8% vs 50% lifetime risk of ASCVD

Men and women with optimal risk status had median life expectancy of 10 years longer than those with 2 or more RF (men +11, women +8)