Doctors work to determine heart disease risk factors
November 9, 1999
Web posted at: 1:40 p.m. EST (1840 GMT)
From Medical Corespondent Steve Salvatore
(CNN) -- Most adults don't experience their first episode of chest pain until they are in their 50s and 60s, but experts say the early signs of atherosclerosis, or hardening of the arteries, start in childhood.
"That's because of the kind of lifestyle we have in the United States," said Dr. Henry Ginsberg of New York-Presbyterian Hospital. "Even our children are eating high-fat diets. Now there's a tremendous increase in overweight children. And those together with inactivity lead to the development of fat in our blood vessels."
Obesity, inactivity and cholesterol levels are just some of the elements doctors use to assess a patient's risk of heart disease and heart attack. For the most part, high-risk and low-risk patients are easy to assess. But most people are somewhere in the middle, and experts say that group is the toughest to treat.
"We really dont know who in that group will have an event in the next year, in the next 10 years, or maybe never," said Ginsberg.
According to the experts at the American Heart Association conference in Atlanta, intermediate risk patients require additional testing to better stratify risk. The question is, which tests?
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"We're looking for the right tests to do. There's a dispute as to whether the tests that are appropriate for high-risk patients, symptomatic patients, are really going to tell us the same thing for the intermediate risk," said Dr. Joseph Tenenbaum of Columbia University Medical School.
You can change your diet or lifestyle to help minimize your risk of heart disease, but what about changing your address? According to a new study, where you live may also help predict your changes of early death from heart disease.
Researchers examined the 1994 death rates from heart disease in men ages 35 to 44. Not surprisingly, the states with the highest incidence of cigarette smoking, Kentucky and Tennessee, had the highest death rates.
"Smoking adds certain substances to your bloodstream that cause damage to the blood vessels; and damaged blood vessels are much more likely to fill up with cholesterol and fat," Ginsberg said.
Of course, genes can also affect risk. Genetic makeup is something no one can control. But experts say by changing lifestyle to reduce risk factors, people can increase their odds of survival.
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New York Presbyterian Hospital: The University Hospital of Columbia and Cornell
Columbia College of Physicians and Surgeons
American Heart Association
American Dietetic Association
National Institutes of Health
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