Study Casts Doubt On Heart 'risk Factors'

International News Electronic Telegraph
Tuesday 25 August 1998
Issue 1187

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Study casts doubt on heart 'risk factors'
By Aisling Irwin, Science Correspondent

External Links

The WHO Monica Project: preliminary analysis of final results [press release, 24 Aug '98] - World Health Organisation

European Society of Cardiology [featuring the European Congress of Cardiology]

World Heart Foundation

Global Cardiovascular Infobase


You can try to prevent heart disease - British Heart Foundation

THE largest ever cardiology study has failed to find a link between heart attacks and the classic risk factors, such as smoking and high cholesterol levels.

The Monica study, which assessed 21 countries over 10 years, found the incidence of heart disease dropping across Europe, Australia and North America. But scientists could find no statistical connection between the reduction and changes in obesity, smoking, blood pressure or cholesterol levels.

"Changing rates of coronary heart disease in different populations did not appear to relate at all well to the change in the standard risk factors," the Monica organisers said in the report published yesterday."This will be a big surprise for many people," said Dr Caroline Morrison, co-principal investigator for the Glasgow contribution to the study.

Public health specialists urged people to continue tackling potential risk factors, pointing out that many other studies had shown that they were linked unequivocally with heart disease. They said the results might give more insight into the difficulties of running trials over huge geographical areas and the unexpected complexity of heart disease, than they did about risk factors.

The results were announced at the European Congress of Cardiology in Vienna. The world's largest and longest heart study amassed information about 150,000 heart attacks, mainly in western Europe but also in Russia, Iceland, Canada, China and Australia. The decrease in the incidence of heart disease was greatest in Sweden, at eight per cent, with a modest drop of two per cent in Glasgow, one of the two British centres that took part. Clear increases were recorded in Lithuania, Poland, China and Russia.

Obesity rose around the world, with the average weight increasing by a couple of kilograms over a decade. The greatest increases were in America, Canada, Australia, Iceland and New Zealand, while weight fell in Russia, Lithuania, Czechoslovakia and, among men only, Switzerland.

Smoking decreased among men in 32 of the 38 centres but, among women, in only 13 centres. Blood pressure dropped almost everywhere in the study. Cholesterol levels remained the same. But scientists failed to find a correlation between these factors and incidence of heart disease.

The World Health Organisation, which funded Monica, said: "That the classical risk factors make major contributions to individual risk has been shown repeatedly in numerous studies."

A possible explanation was that these four risk factors had been swamped by others, said Prof Hugh Tunstall-Pedoe of Dundee University, a member of the Monica steering committee. Unrest, poverty, and social and economic change have all been linked with heart disease since the study began in the early 1980s. Someone who gives up smoking but loses their home may overall be at higher risk of heart disease because of stress.

Eating fruit, vegetables and fish may also play a major role not appreciated - and therefore not recorded - when the study was designed. The study has had many successes, said Dr Morrison. "Locally, it has produced masses of data which is already being used."

28 March 1998 [Etcetera]: Women not in good heart
21 March 1998: Sacking found to be bad for for the heart
8 March 1998: Passive smoking doesn't cause cancer - official
13 February 1998 [UK]: Cancer outstrips heart disease as biggest killer

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