Cutting heart disease risk factors may not reduce death rate

Reported by Susan Aldridge, PhD, medical journalist

Benefits in reducing heart disease risk factors are not as great as had been hoped.
There is increasing emphasis on health promotion - that is, getting people to tackle their risk factors for heart disease such as high blood pressure and high cholesterol. In a new review, researchers at the London School of Hygiene and Tropical Medicine attempted to find out how much benefit we get from risk factor reduction in terms of reduced heart disease and mortality.

They looked at 39 studies covering more than 140,000 patients. They found no obvious impact from small reductions in risk factors on large groups of people when it came to heart disease death rates. One problem may be that the changes measured in risk factors were based on people who stayed in studies and excluded those who dropped out. They also say this review may have missed small, but important, reductions in heart disease from reducing risk factors.

The researchers' message is that those at high risk may still have much to gain from lifestyle modification and drugs to lower blood pressure and cholesterol. Those with low to medium risk of heart disease may still benefit but there is a question of whether this is going to be cost-effective. Therefore, doctors and practice nurses should perhaps target those with the highest risk of heart disease and make sure any interventions are followed up.

Source
Cochrane Database of Systematic Reviews 2006 Issue 4