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Are you among the 1 percent?

Are you among the 1 percent?

Friday, January 13, 2012. The latest issue of the American Heart Association (AHA) journal Circulation reports dismal findings for Americans in regard to their cardioprotective behaviors and factors. In fact, less than 1 percent of a large sampling of adults had an ideal prevalence of all of the seven behaviors and factors examined in the current study.

Christina M. Shay, PhD, who is currently affiliated with the University of Oklahoma Health Sciences Center, and her associates evaluated data from 14,515 men and women aged 20 and older enrolled in the 2003 to 2008 National Health and Nutrition Examination Surveys (NHANES). Physical examinations provided data on body mass index and blood pressure, and blood samples were analyzed for glucose and total cholesterol levels. Questionnaire responses were used to determine smoking status, exercise levels and dietary intake.

The researchers rated as "poor", "intermediate" or "ideal" the following components outlined in the American Heart Association's 2020 Strategic Impact Goals: smoking status, body mass index, physical activity level, Healthy Diet Score components, total cholesterol, blood pressure and fasting blood glucose. Smoking status was the component most consistently rated as ideal among the participants and having a Healthy Diet Score was the most poorly rated component. When participants were analyzed according to age and gender, no young men had an ideal Healthy Diet Score. (Primary goals of the Healthy Diet Score are at least 4.5 cups per day of fruits and vegetables, two or more 3.5 ounce servings per week of fish, three or more one ounce servings per day of whole grains, less than 1500 milligrams per day of sodium, and less than 450 weekly calories of added sugar in sugar-sweetened beverages.) However, young adults had a greater prevalence of ideal body mass index (defined as less than 25.0), physical activity (at least 150 minutes per week of moderate exercise), cholesterol (less than 200 mg/dL untreated), blood pressure (less than 120/80 mm Hg untreated) and fasting glucose (less than 100, untreated). Fewer than one percent of the subjects were rated as ideal for all seven factors.

"Our data indicate that less than 1% of US adults have ideal levels of all 7 cardiovascular health components; these prevalence estimates are even lower in non-Hispanic black and Mexican American adults," the authors write. "Although alarming, these estimates are consistent with recent reports from a middle-aged community-based study population in which only 0.1% of participants exhibited overall ideal cardiovascular health."

"The fact that all components of cardiovascular health are modifiable through treatment and lifestyle should generate optimism for the new strategic directions for the AHA in its research, clinical, public health, and advocacy programs for cardiovascular health promotion and disease prevention," they conclude.

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Seven could give you ten

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A presentation on October 23, 2011 at the Canadian Cardiovascular Congress held in Vancouver recommends the adoption of seven simple measures that could add ten years or more to the average life span.

Dr Clyde Yancy of Northwestern University's Feinberg School of Medicine predicts that "Achieving these seven simple lifestyle factors gives people a 90 per cent chance of living to the age of 90 or 100, free of not only heart disease and stroke but from a number of other chronic illnesses including cancer. By following these steps, we can compress life-threatening disease into the final stages of life and maintain quality of life for the longest possible time."

The steps recommended for Canadians and others include increasing physical activity, knowing and controlling cholesterol levels, following a healthy diet, knowing and controlling blood pressure, achieving and maintaining a healthy weight, managing diabetes and not smoking. These factors, while well known to help reduce the risk of heart attack and stroke, are practiced regularly by only less than 10 percent of the population. "We know how to prevent heart disease and stroke – we now need to build the tools to empower our citizens to manage their risk and prevent heart disease," Dr Yancy noted.

Heart and Stroke Foundation of Canada president Bobbe Wood agreed that "Healthy living is key to preventing heart disease and stroke. The Foundation is committed to raising awareness about heart health and to promoting public policies that facilitate healthy lifestyles and communities."

"The opportunity for prevention is not an unrealistic expectation," Dr Yancy affirmed. "Over the past 40 years the rates of heart disease and stroke have steadily declined."

However, given the rising incidence of obesity and diabetes, he emphasized that "We need to act now."

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