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Despite advancements in safe and effective therapies, the odds of experiencing a second stroke or heart attack have not declined over the past two decades, according to a study from Johns Hopkins Medicine.
The reason? Researchers suggest that adults with cardiovascular disease (CVD) haven’t done enough to reduce factors known to put them at risk for a heart attack, stroke or other CVD event. From 1999 through 2018, the study found a worsening trend (or no improvement) in blood glucose, blood pressure, body mass index (BMI), smoking, physical activity and diet among adults with CVD.
High cholesterol was the only risk factor for which study participants showed a modest improvement over that period. Still, just 30 percent of adults with CVD had an ideal cholesterol profile from 2015 to 2018, according to the study, published in the Journal of the American College of Cardiology.
“We’re not really moving the needle on these risk factors, and that’s leaving a lot of people at risk for recurrent events,” Seth S. Martin, M.D., the corresponding author of the study and an associate professor of medicine in the division of cardiology at the Johns Hopkins University School of Medicine, said in a statement.
The study also revealed persistent racial and ethnic disparities in heart-related health. Access to health care and patient education and the affordability of medications are likely the main drivers of disparities seen in high-risk populations, study coauthor Nino Isakadze, M.D., a cardiac electrophysiology fellow at the Johns Hopkins Hospital, said in a statement. “We have to get innovative about how to reach diverse groups of patients and to improve secondary prevention in everyone with cardiovascular disease.”
Among the best ways to reduce your risk of heart disease is to avoid smoking, exercise regularly, get a good night’s rest, and eat a diet rich in fruits, vegetables, whole grains, nuts and legumes, according to the American Heart Association (AHA). You should also keep track of your blood pressure, cholesterol levels, blood sugar levels and body mass.
What the researchers did
For this study, researchers used data collected by the National Health and Nutrition Examination Survey from 1999 to 2018. The survey involved 6,335 adults with a self-reported history of coronary heart disease, myocardial infarction, stroke, angina or congestive heart failure. Participants were about evenly split between men and women. The majority were white, 13 percent were Black, 10 percent were Hispanic, and 3 percent were Asian.
The researchers created a scorecard for cardiovascular health, including ideal measures for seven metrics (based on the AHA’s “Life’s Simple 7”). The AHA checklist was updated this year to “Life’s Essential 8,” adding seven to nine hours of sleep a night to the list. That metric was not included in this study.