Stop smoking, watch your weight, keep blood pressure and cholesterol readings at recommended levels and exercise regularly, and your risk of dying from a heart attack can be lowered significantly, said Dr. Jeffrey Hoeg, of NIH's National Heart, Lung, and Blood Institute.

Citing research into the more-active, less-affluent lifestyles of such countries as India, Peru and Afghanistan--countries that have a very high prevalence of elderly, as many as 10 per 800 over age 80--Hoeg stated, "It's clear that the caloric expenditure and the physical activity, as well as the caloric intake, is very different between our society and theirs. Americans start getting deposits of cholesterol in their arteries as teenagers and young adults."

In the United States, about 500,000 deaths are related to coronary heart disease annually. However, since 1970, there has been a dramatic fall here in the incidence of heart disease. Hoeg attributes much of the decline to lifestyle changes.

"People are reading food labels to reduce their intake of saturated fat and are exercising more; these factors in large part account for the reduction in cardiovascular diseases--such as heart attacks, high blood pressure and strokes--that our society has enjoyed over the last 25 years," he said.

Risk factors for heart disease that Hoeg identifies as controllable include cigarette smoking, high blood pressure, high levels of LDL (low density lipoproteins or the so-called "bad" cholesterol), low levels of HDL (high density lipoprotein or "good" cholesterol), diabetes and obesity.

These "classic" risk factors have been well publicized, Hoeg said, but most importantly, they have been well proven by clinical trials. The hallmark of good research is that it has cleared every stage of the scientific process, from initial theory, to laboratory studies, to large-scale clinical trials--the gold standard of testing in humans--he added.

Hoeg says manufacturers of new products or therapies often claim health benefits too soon--before the crucial clinical trials have been done that will prove or disprove the claims. Good consumers of health information should differentiate between preliminary research in small numbers of people and well-proven clinical results from large-scale clinical trials. "Hypotheses are cheap," he pointed out, "but it's the facts that are very expensive."

Hoeg also noted risk factors that cannot be modified, including gender, age, and family history of disease. Equal numbers of men and women die of heart disease every year, but women die about 10 years later than men, he explained.

"Biomedical research and clinical investigation are the key to improved health in the 21st century," Hoeg stressed. He predicted that advances in technology will enable doctors to detect and assess the level of heart disease at earlier, more treatable stages. "Ever-improving diagnostic devices such as ultrasound and magnetic resonance imaging will soon allow scientists to see heart blood vessels more clearly than ever. This will help physicians find and treat trouble spots before they become more severe problems. The ideal would be to identify individuals at a very young age and then subject them to a treatment that would then prevent them from ever developing the disease.

"Maintaining one's ideal body weight, blood pressure and blood cholesterol leads to a healthy heart," Hoeg concluded. --an NIH HEALTHWise report, January 1998

For more information on this article, reporters can contact:

Carla Garnett
Writer and Editor, NIH
Phone: 301-496-2125
Fax: 301-402-1485
E-mail: cg9s@nih.gov

For more information on prevention and treatment of heart disease, reporters can contact:

National Heart, Lung, and Blood Institute
Communications Office
Phone: 301-496-4236

For inquiries, booklets and other public education materials, individuals can contact:

The NHLBI Information Center
Attention: HEALTHWise
PO Box 30105
Bethesda, MD 20824-0105
Phone: 301-251-1222
Fax: 301-251-1223

To hear prerecorded information about two of the "classic" risk factors--high blood cholesterol and high blood pressure--call NHLBI's toll free number, 1-800-575-WELL (9355).

In addition, NHLBI lists its available publications and resources (some of which are available in Spanish) online at its website. The URL is http://www.nhlbi.nih.gov/nhlbi/nhlbi.htm.

^a includes stroke and other diseases or conditions involving hemorrhage or blockage of blood vessels in the brain
^b chronic, obstructive lung diseases including mainly bronchitis, emphysema and asthma