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Wereldwijde studie vindt risicofactoren voor
hartinfarct*
Uit een studie onder 29.000 mensen in 52 landen werden 9
risicofactoren voor een hartinfarct gevonden .De 2 meest belangrijke zijn: roken
en hoge bloedwaarden aan apolipoproteinen.. Deze 2 veroorzaken 2/3 van alle
hartinfarcten. Verdere risicofactoren zijn: hoge bloeddruk, diabetes, vetzucht
in de buikstreek, stress, het eten van te weinig groente en fruit, te weinig
bewegen. Het matig drinken van alcoholhoudende dranken geeft ook minder risico.
HAMILTON ONTARIO
(August 29, 2004)--A major Canadian-led global study has found that the vast
majority of heart attacks may be predicted by nine easily measurable factors and
that these factors are the same in virtually every region and ethnic group
worldwide.
The INTERHEART
study looked at more than 29,000 people in 52 countries and from all inhabited
continents of the world. The study was presented today at the European Society
of Cardiology (ESC) conference in Munich, Germany by Dr. Salim Yusuf, a
professor of medicine at the Michael G. DeGroote School of Medicine at McMaster
University and director of the Population Health Research Institute at McMaster
University and Hamilton Health Sciences, which coordinated the study.
The study found
that the two most important risk factors are cigarette smoking and an abnormal
ratio of blood lipids (Apolipoprotein B/Apolipoprotein A-1), which together
predicted two-thirds of the global risk of heart attack. Additional risk factors
are high blood pressure, diabetes, abdominal obesity, stress, a lack of daily
consumption of fruits and vegetables and a lack of daily exercise. Regular
consumption of small amounts of alcohol was also found to be modestly
protective. Worldwide, these nine factors collectively predict more than 90 per
cent of the risk of a heart attack.
The INTERHEART
study, one of the largest case control studies examining the importance of heart
disease risk factors, involved 15,152 individuals with their first heart attack
and 14,820 others who did not have heart disease but who were of the same age,
gender, and from the same city. The study was funded by the Canadian Institutes
of Health Research, the Heart and Stroke Foundation of Ontario and 37 other
funding sources, including unrestricted support from several pharmaceutical
companies.
This major study is
the first examination of whether risk factors for heart attack have a similar or
different impact in all major ethnic groups and major areas of the world. It
included 7,000 people of European extraction; 2,000 from Latin America, 6,000
Chinese; 4,000 South Asians; 2,000 from other parts of Asia; 3,500 Arabs and
1,400 Africans. There were 450 Canadians included. Yusuf said conventional
wisdom had previously suggested that only half of the risks of heart attacks may
be foreseen, but the INTERHEART findings mean the overwhelming majority of heart
attack risk may be predicted.
"These risk
factors appear to predict the majority of the risk in virtually every region,
every ethnic group, in men and women and in the old and the young," said
Yusuf. "This suggests that the message of preventing cardiovascular disease
can be quite simple and, generally, similar across the world, after taking into
account economic and cultural differences.
"Since these
risk factors may all be modified, this is remarkable and will change the way we
look at heart attack prevention. It means we should be able to prevent the
majority of premature heart attacks in the world."
Dr. Anthony Graham,
cardiologist and spokesperson for the Heart and Stroke Foundation, said:
"The Heart and Stroke Foundation recently reported that eight out of 10
Canadians have at least one risk factor for developing heart disease or stroke.
Developing a better understanding of these risks and the root causes of heart
disease and stroke through research, and sharing that information with the
public is a priority for the Foundation."
Dr. Alan Bernstein,
president of the Canadian Institutes of Health Research, pointed out that
worldwide there is a growing epidemic of cardiovascular disease with more than
15 million deaths from heart attacks in 1998 alone.
"This is a
landmark study. It suggests that a combination of lifestyle changes including
stopping smoking, eating a healthier diet and exercising could lead to an 80 per
cent reduction in the risk of heart attacks," he said. "The INTERHEART
study provides the health research evidence needed to build national and
international programs for the prevention and control of one the leading cause
of death in Canada and world-wide."
The INTERHEART
study is scheduled to be published in the prestigious medical journal The Lancet
on Sept. 11, 2004 but will be available on its website at www.thelancet.com on
Friday, September 3.
That issue will
also include a second article from the study on the factor of stress as a risk
attribute for heart attacks. It found that various simple measures of patient
stress and psychosocial status were able to predict the risk of heart attacks,
said its lead author, Dr. Annika Rosengren, professor of cardiology at Göteborg
University, Sweden.
"Collectively,
these were responsible for about one-third of the risk in the population
studied," said Rosengren.
Dr. John Kelton,
dean of the Michael G. DeGroote School of Medicine and dean and vice-president,
Faculty of Health Sciences, McMaster University, said: "The results of this
massive study will change public health policy around the world. Different
countries will be able to pinpoint risk factors for their people and address the
root causes of heart disease."
Mr. Murray Martin,
CEO of the Hamilton Health Sciences of Hamilton, said: "Part of our mission
as an academic teaching hospital is to advance health care through education and
research. Dr. Yusuf's commitment to finding answers to important heart health
questions that affect people around the world exemplifies the type of leadership
we embrace at Hamilton Health Sciences."
###
The INTERHEART
study was endorsed by the World Health Organization, the World Heart Federation,
and the International Clinical Epidemiology Network. (aug.
2004)
Opmerking Het gehalte aan
apolipoproteinen in het bloed - een eiwit dat cholesterol vervoert in het
lichaam - is een betere test om het risico op een fatale hartaanval te
voorspellen dan het cholesterolgehalte zelf.
Apolipoproteine B (apoB) is drager van het 'slechte'
LDL-cholesterol (en van VLDL-cholesterol), terwijl apolipoproteine A-1 (ApoA-1)
de goede HDL-cholesterol vervoert. Probleem is momenteel dat er nog geen goede
gestandaardiseerde en gemakkelijke tests voor die apolipoproteinen bestaan.