March 4, 2011 / 11:18 PM / in 7 years

Americans fall short of "ideal" heart health

NEW YORK (Reuters Health) - A new study finds only one out of nearly 2,000 middle-aged Americans hit the mark for ideal heart health as defined by the American Heart Association (AHA).

That entails acing the AHA’s seven-item checklist, which includes being physically active, not smoking, having a healthy weight and diet, as well as staying below certain thresholds for cholesterol, blood pressure and blood sugar levels.

Not meeting any one of those goals would be a risk factor for developing heart disease, the leading killer worldwide.

“I was surprised that so few study participants met the AHA’s goals, because this was a self-selected group that volunteered to participate in a study focusing on cardiovascular health,” including heart attacks and stroke, study author Dr. Steven E. Reis told Reuters Health in an e-mail.

“Heart health may be achieved by changing behaviors, such as becoming a nonsmoker or losing weight,” added Reis, a cardiologist at the University of Pittsburgh. “Although this may be very difficult for many individuals to achieve, it is these kinds of changes that can lead to healthy blood pressure, cholesterol and (blood sugar) levels and, in turn, to ideal cardiovascular health.”

The AHA released its "Simple 7" ( criteria in January 2010, with the goal of reducing deaths from heart disease by at least 20 percent by 2020.

Today, a third of all U.S. deaths are due to heart disease, so judging from the latest findings it might take a lot of work to reach AHA’s goal.

A healthy level of activity means exercising each week, while eating healthily includes getting lots of fish, fruits and vegetables and other foods low in saturated fat, salt and added sugar.

The AHA says total cholesterol should be less than 200 milligrams per deciliter without medical treatment; the top blood pressure (systolic) reading should be less than 120 and the low (diastolic) less than 80; and the fasting blood sugar concentration should be below 100 milligrams per deciliter.

Dr. Reis and his colleagues analyzed data for 1,933 middle-aged men and women in Allegheny County, Pennsylvania, which includes Pittsburgh. Of those, a little less than half were black and two-thirds were women.

Most had been to college and earned at least $40,000 a year.

Heart-healthy lifestyles were uncommon among the volunteers, even when the researchers used more forgiving criteria: Fewer than one in ten people in the study met five or more items on the checklist, and only about two in 10 met four.

Blacks were much less likely than whites to meet the criteria, the researchers report in the journal Circulation.

Bad behaviors abounded. More than 80 percent of study participants were overweight or obese, while 61 percent weren’t eating enough heart-healthy foods.

Although nearly a quarter of participants reported getting regular exercise, most either did so sporadically or were inactive.

Meanwhile, almost three-quarters of people in the study had either dangerously high or elevated cholesterol, and 85 percent had elevated or high blood pressure.

So is the AHA’s 2020 target woefully unrealistic?

In an editorial accompanying the journal article, Dr. Clyde W. Yancy, past president of the group, said no -- although reaching it may require “a moonshot mentality.”

Yancy mentioned the better-than-expected achievements of an earlier effort by the AHA to reduce deaths from heart disease by a quarter by 2010.

“Clearly, there is much work to be done,” Yancy wrote, “but we can and should address this goal with the ingenuity and fervor that previously spurred our success.”

Reis agreed, noting that “it would be inappropriate to lower the goals just because few individuals meet them.”

“Rather, our data suggest that we should increase our efforts to assist individuals to achieve heart health,” he said.

SOURCE: Circulation, February 14, 2011.

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