The Pharmaceutical Journal
Vol 273 No 7315 p305
4 September 2004

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Nine risk factors that will predict most heart attacks

Nine easily measured risk factors can predict more than 90 per cent of heart attacks, according to a major global study.

The INTERHEART study, reported at the European Society of Cardiology in Munich this week, matched 15,152 people suffering a first myocardial infarction (MI) with healthy controls for age and sex. Researchers systematically assessed the relationship between a wide range of factors and the risk of MI and found nine significant factors.

The leading risk factor was raised lipids —measured as the ratio of apolipoprotein B to apolipoprotein A-1. People in the highest quintile had nearly four times the risk of MI as those in the bottom quintile. Smoking was the second most important risk factor, with current smokers at nearly three times the risk of MI as non-smokers. Diabetes imposed a similar tripling of MI risk, while hypertension increased risk by 2.5 times. Abdominal obesity and psychosocial stress doubled MI risk. Low daily consumption of vegetables and fruit, taking little regular exercise, and excessive (or no) alcohol intake are the other factors.

The risk factors were multiplicative, so that a person with all of them was at more than 100 times the risk of an MI (odds ratio 129.2) as someone without any risk factors.

The study leader, Salim Yusuf, professor of medicine, McMaster University, Hamilton, Ontario, said: “The vast majority of heart attacks can be predicted by nine easily measurable factors. It has previously been thought that only half of the risk of MI could be foreseen, but the findings mean that the overwhelming majority of heart attack risk can be predicted.”