From Heartwire
Shelley Wood
men who smoked, were inactive, and who had a waist girth >94 cm had an overall life expectancy that was 14 years shorter
December 16, 2009 (Chicago, Illinois) — Everyone agrees: smoking, physical inactivity, and abdominal obesity increase the risks of coronary heart disease (CHD), but just how much are risks reduced in those who can claim "none of the above"?
A new study appearing in the December 14-28, 2009 issue of the Archives of Internal Medicine indicates that men with none of these risk factors had a 59% lower risk of CHD events and a 77% lower risk of dying of cardiovascular disease [1]. The authors say their study may be the first to estimate the "combined health benefits" of not smoking, having good cardiorespiratory fitness (measured by max treadmill test), and a normal waist girth.
Dr Chong-Do Lee and colleagues followed 23 657 men age 30 and older for a mean of almost 15 years (348 811 person-years) in the Aerobics Center Longitudinal Study (ACLS).
Over this period, 482 men had a fatal or nonfatal MI, and 1034 died of noncardiac causes. After adjusting for age, year of initial medical examination, and baseline risk factors, Lee et al found that risk of a CHD event or of dying of cardiac or noncardiac causes was inversely related to the presence of "low-risk factors."
Men with a normal waist circumference, who kept physically active, and who didn't smoke were significantly less likely to have a CHD event or die of cardiac causes, as compared with men with none of these low-risk factors. Risk of all-cause mortality was also dramatically lower in this group.
By comparison, men who smoked, were inactive, and who had a waist girth >94 cm had an overall life expectancy that was 14 years shorter.
Investigators underscore a number of limitations in their study: the study cohort comprised mainly white, middle- to upper-class men and importantly, did not address changes in low-risk factors over the follow-up period. But overall, they say, their findings speak to the importance of adhering to healthy behaviors and a healthy weight over the long term.
"The magnitude of having the three low-risk factors is impressive for both population-attributable risk and for longevity and indicates the clinical and public-health importance of these characteristics," Lee et al conclude.
Easier said than done, perhaps. Citing a 2006 paper by Chiuve et al [2], Lee and colleagues point out that "low-risk" Americans, who have a normal weight in combination with a healthy lifestyle, make up just 3% to 4% of the population.
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