Posted: September 5, 2019
Most cardiovascular events avoidable with modest blood pressure and cholesterol reductions
The majority of heart attacks, strokes, and deaths from heart disease can be prevented with modest and sustained decreases in blood pressure and cholesterol. These late breaking results were presented in a Hot Line Session today in Paris at the ESC Congress 2019 together with the World Congress of Cardiology and published in the Journal of the American Medical Association.
Healthy eating and physical activity are effective ways to improve cardiovascular health. The best diet or exercise program differs for each person. This study, using the powerful tool of Mendelian Randomization, shows that even modest lifelong strategies to reduce both blood pressure and LDL cholesterol have dramatic long-term benefits.
The relationship was both additive and dose-dependent, meaning that any combination of lower LDL-C and lower blood pressure was associated with a corresponding large reduction in lifetime risk of cardiovascular disease.
Even small declines in LDL and BP can substantially diminish the likelihood of ever having a heart attack or stroke. For example, the combination of 14 mg/dL lower LDL and 5 mmHg lower BP was associated with a 50% lower lifetime risk of cardiovascular disease.
Larger reductions in LDL and BP with more aggressive lifestyle changes or other therapies to achieve the combination of about 40 mg/dL lower LDL and 10 mmHg lower BP can reduce lifetime risk of cardiovascular disease by 80% and reduce lifetime risk of cardiovascular death by more than two-thirds!
The researchers used genetic variants linked with lower LDL and BP as instruments to randomly divide participants into groups with lifetime exposure to lower LDL, lower BP, or both as compared to a reference group. They then compared the differences in LDL, BP and cardiovascular event rates between the groups to estimate associations with lifetime risk of cardiovascular disease.
Maintaining even small reductions in both LDL-C and SBP for prolonged periods of time can pay very big health dividends by dramatically reducing the lifetime risk of cardiovascular disease.
Lower is always better!
From Paris, À votre santé!
John A. Osborne, MD, PhD, FACC, FNLA
Director of Cardiology, LowT Center/HerKare
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