Study: U.S. Heart Disease Prevention Is Working

One of the largest and longest-running studies on heart health has demonstrated just how powerful cardiovascular disease prevention methods can be.  

People participating in the Framingham Heart Study, which is designed to help identify major risk factors for heart disease and their effect on the heart, are living longer and having less of a risk of developing a heart attack or stroke, or dying from coronary heart disease, per a new analysis.

The analysis, which was published in the journal Circulation, looked at data from more than 24,000 people participating in the ongoing study, which started in 1948. The researchers specifically looked at someone’s lifetime risk from age 45 for having a heart attack or stroke, or dying from coronary heart disease during three periods of time: 1960–1979, 1980–1999, and 2000–2018.

The researchers found that overall life expectancy increased by 10.1 years for men and 11.9 years for women over the three time periods. The remaining lifetime risk of developing heart disease dropped between 1960–1979 and 2000–2018 from 36.3% to 26.5% in women and from 52.5% to 30.1% in men.

For study participants who experienced any cardiovascular events, they occurred later in life for both men and women. Specifically, from 2000 to 2019, the average age of a first cardiovascular event was 8.1 years later for men and 10.3 years later for women, when they were compared to the 1960–1979 group.

These findings underscore the importance of “continued and effective primary prevention efforts with better screening for risk factors and their effective treatment,” the researchers wrote.

Heart Disease Prevention Methods

The study didn’t dive into which heart disease prevention methods are the most effective, but the American Heart Association (AHA) generally recommends that people do the following to lower the risk of developing heart disease:

• Eat a healthy diet. Focus on fruits, vegetables, whole grains, legumes, nuts, plant-based proteins, lean animal proteins, and fish. Limit refined carbohydrates, processed meats, sweetened drinks, sodium, added sugars, and saturated fats.
• Be physically active. Aim for at least 150 minutes a week of moderate-intensity aerobic activity or 75 minutes of vigorous activity.
• Manage your weight. Maintain a healthy weight. And, if you have overweight or obesity, work with a healthcare provider to help you lose weight.
• Don’t smoke. Avoid using tobacco products. If you don’t smoke, vape, or use tobacco products, don’t start.
• Manage existing conditions. High blood pressure, high cholesterol, high blood sugar, and diabetes raise your risk of heart disease. Keep them under control to help lower your risk.
• Take your medicine. Take medication as prescribed by a healthcare provider to lower your overall risk of heart disease.

There Is Still Work to Be Done

The study’s findings are “very interesting,” but they have limitations, Jennifer Haythe, MD, an associate professor of medicine and director of the cardio-obstetrics program at the Columbia Women’s Heart Center, told Verywell.

“The biggest limitation of this study is that it reflects a predominantly White cohort and therefore does not accurately represent the ethnic and racial makeup of the United States,” she said.

It’s also focused on people who live in the northeastern part of the U.S., which “may not represent that of the entire country or of other countries,” Paul Natterson, MD, a cardiologist at Providence Saint John’s Health Center in California, told Verywell.

But Jennifer Wong, MD, cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California, told Verywell that the findings are “not surprising” and reflect what many doctors are seeing.

“We’ve been better at promoting preventative measures in recent years and there are improved therapies for primary and secondary prevention,” she said. “Statins [which lower cholesterol] first became available in the 1980s and probably have been a big difference-maker. We’ve also been more aggressive with blood pressure control.”

“More aggressive intervention” aimed at risk factors like hypertension, diabetes, high cholesterol, and tobacco use also likely factor in, Haythe said.

But Natterson emphasized that there is still work to be done.

“People continue to experience atherosclerotic cardiovascular disease and its consequences,” he said. “While we are doing a better job addressing the key risk factors and behaviors that lead to heart and vascular disease, we are not entirely eliminating heart attacks and strokes. Instead, we are often simply delaying the age until such events take place, on the order of 10 years.”