For young women, a low cardiovascular risk profile is associated with lower long-term heart disease

Young women at low risk for coronary heart disease and cardiovascular diseases have a lower long-term death rate from these diseases and all other causes compared with others with higher risk factor levels, according to an article in the October 6 issue of JAMA.

Background information in the article states: "Young adult men and middle-aged men and women with favorable levels of all major cardiovascular risk factors, i.e., low-risk status, have much lower age-specific risks for cardiovascular disease (CVD) and all-cause mortality than those with adverse levels of one or more risk factors." However, this relationship has not yet been studied in young women.

Martha L. Daviglus, M.D., Ph.D., of the Feinberg School of Medicine, Northwestern University, Chicago, and colleagues examined the relationship between the presence of low levels of risk factors for coronary heart disease (CHD) and cardiovascular disease (CVD) in young adulthood and long-term incidence and cause of death in women. The Chicago Heart Association (CHA) Detection Project in Industry Study screened approximately 40,000 people 18 years and older from 1967 to 1973. Those at risk for CHD and/or CVD were classified using national guidelines for values of blood pressure, cholesterol, body mass index, diabetes, and smoking status.

Of the 7,302 women, 20.1 percent were classified as at a low risk for CHD and CVD. A majority of the cohort (58.5 percent) had high levels of one or more risk factors. In general, women at low-risk were younger, white, and better educated. During an average 31 years of follow-up, there were 47 CHD deaths, 94 CVD deaths, and 469 all-cause deaths. "The age-adjusted CVD death rate per 10,000 person-years was lowest for low-risk women and increased with the number of risk factors...," the authors write.

The authors write: "Our findings show that for young women, a low cardiovascular risk profile is associated with lower long-term CHD, CVD, and all-cause mortality-results in concert with previous findings on young men and middle-aged men and women. They demonstrate that among persons at low risk earlier in life, CHD and CVD cease to occur at epidemic rates. These data underscore the importance of a national public priority emphasizing prevention and control of all major CVD risk factors by lifestyle approaches from conception, weaning, childhood, and youth on to increase proportions of the population at low CVD risk."