Wednesday, March 21, 2012

Grade Inflation and The American Cardiovascular Report Card

     A study published this week in the Journal of the American Medical Association examined the correlation between a set of cardiovascular health metrics and death over the past 20 years. This is an important issue because cardiovascular disease (CVD) is the number one killer in the US causing more than 800,000 deaths per year (1 in 3 of all deaths), with an estimated annual overall cost of $444 billion.

     Because sound research has demonstrated a correlation between certain behaviors/lab values and CVD, the American Heart Association (AHA) launched a targeted campaign. The AHA identified three categories of individuals with regard to CVD; ideal, intermediate, and poor.

     No one will be surprised that few americans made it into the ideal category. After all, what does it mean to have ideal cardiovascular health? A heart like Lance Armstrong? 5 minute mile? 50 flights of stairs with a pulse of 60? IDEAL! Right?


     AHA definition of Ideal:

     No Smoking
     Physically Active
     Normal Blood Pressure
     Normal Blood Glucose
     Normal Total Cholesterol
     Normal Weight
     Eating a Healthy Diet

     Pretty ordinary sounding stuff. So here's the knock out. Less than 2 percent of adult Americans meet these criteria.

    There is some good news. Smoking has declined since 1988.

    But the blood pressure and cholesterol categories have not changed, while weight, diet, and blood glucose have worsened.

     People who met 6 or more vs 1 or fewer of these measures had a 51% lower risk of all-cause mortality and a 76% lower risk of CVD. Interestingly, meeting more of the cardiovascular measures was associated with lower risk for all-cancer mortality as well.

     You really only have to nail 3 of the 7. Eat right, don't smoke, and move. The rest follows.

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