Key factors in reducing the risk of heart and circulatory diseases
Modest and sustained decreases in blood pressure and cholesterol levels reduces the lifetime risk of developing fatal heart and circulatory diseases, such as heart attack and stroke, according to research part-funded by the British Heart Foundation (BHF) and supported by the National Institute for Health Research (NIHR).
The findings are being presented at the European Society of Cardiology (ESC) Congress in Paris and published in the Journal of the American Medical Association (JAMA).
Researchers have found that a long-term reduction of 1 mmol/L low-density lipoprotein (LDL), or ‘bad’ cholesterol, in the blood with a 10 mmHg reduction in blood pressure led to an 80 per cent lower lifetime risk of developing heart and circulatory disease.
This combination also reduced the risk of death from these conditions by 67 per cent.
The team found that even small reductions can provide health benefits. A decrease of 0.3 mmol/L LDL cholesterol in the blood and 3 mmHg lower blood pressure was associated with a 50 per cent lower lifetime risk of heart and circulatory disease.
Scientists have previously found that lowering both blood pressure and the amount of ‘bad’ cholesterol in the blood are two ways which can prevent the onset of heart and circulatory disease. However, the risk, which accumulates over time, has not been quantified before.
In this study, Professor Brian Ference and his team studied 438,952 participants in the UK Biobank, who had a total of 24,980 major coronary events – defined as the first occurrence of non-fatal heart attack, ischaemic stroke or death due to coronary heart disease. They used an approach called Mendelian randomization, which uses naturally occurring genetic differences to randomly divide the participants into groups, mimicking the effects of running a clinical trial.
People with genes associated with lower blood pressure, lower LDL cholesterol and a combination of both were put into different groups, and compared against those without these genetic associations. Differences in blood LDL cholesterol and systolic blood pressure (the highest level that blood pressure reaches when the heart contracts), along with the number of cardiovascular events was compared between groups.
Professor Brian Ference now hopes that these findings can bring about change in the healthcare of people at greater risk of developing heart and circulation complications, and improved guidance for those requiring lifestyle changes.
British Heart Foundation