Almost 90% of adults in the United States over the age of 20 are at risk of developing heart disease, a startling new study suggests.
The unexpectedly high numbers do not mean that the majority of adults in the United States have full-blown heart disease, but many people, even young people, are at risk for developing heart disease. It shows that there is.
Researchers used a recently defined syndrome that takes into account the strong links between heart disease, obesity, diabetes and kidney disease to target people at high risk, according to study results published Wednesday in JAMA. Identified.
In October, the American Heart Association warned doctors about: Cardiovascular, renal, and metabolic (CKM) syndrome, a condition that affects major organs of the body, such as the brain, heart, liver, and kidneys. CKM is diagnosed on a scale from zero (no risk factors for heart disease) to four (people who have been diagnosed with heart disease and have excess body fat, metabolic risk factors such as high blood pressure or diabetes, or kidney disease) .
For the new study, researchers analyzed nearly 10 years of data from more than 10,000 participants in the National Health and Nutrition Examination Survey (NHANES).
“We were really surprised that almost 90% of people met the criteria,” said study co-author Dr. Rahul Agarwal, a cardiology fellow at Brigham and Women’s Hospital at Harvard Medical School. “This number was much higher than we would have expected with a database that includes young adults.”
Of particular concern, nearly 50% of NHANES participants were in stage 2 of CKM, meaning they had either high blood sugar, high blood pressure, high cholesterol, or chronic kidney disease, meaning they were at moderate risk. Mr. Agarwal said that the result was that
Just over a quarter of the group (those listed as stage 1) are at high risk of developing heart disease due to obesity or overweight, excess abdominal fat and fat around organs, but no special symptoms There wasn’t.
The researchers found that 15% of participants had advanced disease, and that number remained roughly constant from 2011 to 2020.
“I think one of the biggest reasons why the percentage of people with advanced stage disease is not improving is obesity. Obesity is very prevalent in the United States,” Agarwal said, adding that 40% of Americans are obese. It added.Additionally he is 32% overweight Based on BMI calculationaccording to the Centers for Disease Control and Prevention.
Carrying excess weight makes you more likely to have high blood pressure, high blood sugar, and high cholesterol, but some people have metabolic risk factors even at a healthy weight.
Participants aged 65 and older were more likely to have advanced stage disease than those aged 45 to 64. But being young wasn’t as protective as one might imagine. Only 18% of people between the ages of 20 and 44 were in stage 0. That is, they had no risk factors.
Agarwal said the new findings show health care providers need to recognize these symptoms early “before they lead to downstream effects” such as an increased risk of heart attack, heart failure and stroke. He said there was. “We need to diagnose it earlier and treat it more aggressively.”
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Lifestyle changes, such as improving your diet and increasing your activity level, can help prevent heart attacks and strokes.
The findings also show that “young adults, people under the age of 45, are not as healthy as we think,” Agarwal said.
Experts were also surprised by the high CKM rate.
“It’s alarming that 90% of the population has at least stage 1 disease and only 10% have no risk factors for invasive heart disease.” said Dr. Sripal Bangalore, dean. .
He blames these numbers on the overweight and obesity epidemic.
“There is much work to be done to reduce rates of overweight and obesity,” Bangalore said. “If we can do that, we hope to be able to reduce the number of people who go on to Stage 2 and then reduce the number of people who go on to the higher stages.”
Including kidney disease in cardiovascular disease risk assessments makes a lot of sense, says Dr. Adriana Hung, a nephrologist, epidemiologist, and professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. Stated.
“Kidney disease worsens cardiovascular disease,” she said. “Several studies have shown that patients have a six-fold increased risk of dying from cardiovascular disease if they also have kidney disease.”
A new, broader approach to heart disease could help identify more people at risk, says Dr. Robert Rosenson, director of lipids and metabolism at Mount Sinai Health System in New York City. said that it was high.
“The main message from this study should be that many common behaviors lead to a lifelong accumulation of disease, which impacts quality of life and survival,” he said.
Rosenson added that the high number of people with CKM in this study is related to overweight and obesity, insulin resistance, and a diet high in fat and salt.
He said people need to realize that it’s not just the heart that is negatively affected by an unhealthy diet and lack of exercise, but lifestyle factors can also affect cognition.
