Young women who are heart-healthy and work to stay that way are likelier to see that lifestyle pay huge dividends in their later years, a new study finds.

Women who have normal blood pressure, normal cholesterol and normal body weight in their youth, and who don't have diabetes and don't smoke, are less likely to die from heart disease as they age, compared with women with one or more of these risk factors, the study finds.

Although a favorable risk profile has been shown to reduce the death rate from heart disease among men and middle-aged women, this is the first time it has been shown to benefit young women, according to the report in the Oct. 6 issue of the Journal of the American Medical Association.

"We found the rate of mortality from cardiovascular and all-cause mortality is much lower in women with no risk factors compared with those who have one or more risk factors," said study author Dr. Martha L. Daviglus, an associate professor of preventive medicine and clinical pharmacology from Northwestern University.

"All of the cardiovascular risk levels that we call favorable are really the recommendations for a normal profile," she added. "All young women in the U.S. should be following these recommendations."

In its study, Daviglus's group collected data on 7,302 women 18 to 39 years of age. The women were part of the Chicago Heart Association Detection Project in Industry study, which included a total of 39,522 men and women.

Between 1967 and 1973, these women were identified as not having heart disease. Based on their risk factors, they were assigned to four risk groups. The researchers found that 20.1 percent of the women were at low risk for heart disease, but 58.5 percent had one or more risk factors. Most of the women in the low-risk group were younger, white and better educated than their counterparts at higher risk.

Over 31 years of follow-up, 141 women died from coronary heart disease and coronary vascular disease, and 469 died from all other causes.

Even though there were changes over time in heart disease risk factors, the lowest death rate from heart disease and all other conditions was seen among women in the low-risk group. The rate increased as the number of heart disease risk factors increased, the researchers report.

Despite increases in risk factors over time, those who had no risk factors when they were young still had a lower mortality rate as they aged, Daviglus said.

"This is not genetically determined," she said. "Young women should try to be at low risk. They should exercise, not smoke, control their weight and blood pressure and cholesterol. Then they will be OK."

Daviglus added that if you are middle-aged, it's not too late to change your lifestyle and improve your health. "But the younger the better," she said.

"Young people whose lives are still relatively uncomplicated by adverse risk factor levels need to stay at low risk by pursuing a healthy lifestyle -- avoiding or quitting smoking, adopting healthy eating patterns, and remaining or becoming physically active," Daviglus advised.

"Heart disease risks are early, not overnight," said Dr. Nieca Goldberg, chief of women's cardiovascular care at Lenox Hill Hospital and a spokeswoman for the American Heart Association. Risk factors at an early age help predict the risk of heart disease in the future, she added.

"Young women really should be physically active, watch what they're eating, reduce saturated fats in their diet, eat more fruits and vegetables, whole grains and good fats, and not smoke," Goldberg said.

"This study underscores the importance of maintaining a low-risk profile," said Dr. Lori Mosca, an associate professor of medicine at Columbia University College of Physicians and Surgeons and director of Preventive Cardiology at New York-Presbyterian Hospital.

"A striking feature is that very few women actually have a low-risk profile," she said. Mosca, who was chairwoman of the American Heart Association committee that wrote the new guidelines for women, added, "This highlights the need to implement the American Heart Association guidelines for women that were published this year."

Young women need to maintain a heart-healthy lifestyle, Mosca said. This includes reducing high blood pressure and cholesterol. "This study suggests that if they do, they will live longer," she said.

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Reference Source 101
October 6, 2004

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