Risk factors in your 40s increase chance of heart attack later in life

When you go for your physical or assess your risk for heart disease with an on-line risk calculators, you typically find out your risk of a heart attack or stroke over the next five to 10 years.

If it’s low, you’re usually reassured that you’re healthy and, though you could eat better and exercise more, you needn’t worry. But this approach may be misguided and dangerous, according to a new study.

The study, published in the New England Journal of Medicine, found that even when a middle-aged individual’s risk was low, his or her lifetime risk could still be perilously high.

“The majority of adults in the United States who are considered to be at low risk for cardiovascular disease in the short term are actually at high risk across their remaining lifespan,” the authors wrote.

Focusing on short term risks may be giving people a false sense of security, or in other words, a license to continue with some of their unhealthy lifestyles.

“The risk factors we develop in younger and middle ages are going to determine our heart disease risk across our lifetime,” said the study’s lead author Dr. Jarett Berry, assistant professor of internal medicine at UT Southwestern Medical Center.

“What determines your heart disease risk when you are 70 or 80 is what your risk factors are when you’re 40,” he said.

Berry and his researchers looked at data collected in the Cardiovascular Lifetime Risk Pooling Project of more than 254,000 participants over the last 50 years. They found that people with two or more major risk factors by age 45 or 55 had dramatically higher lifetime risks for cardiovascular death, heart attack and stroke across the lifespan. They had as much as 10 times the rates of those without risk factors. For example, the lifetime risk of ever having a heart attack for a 45-year-old man with no risk factors is 1.7 percent compared to a lifetime risk of 42 percent if he had two major risk factor at age 45.

Major risk factors included smoking, diabetes, high cholesterol (or being treated for it), and high blood pressure (or being treated for it).

“If we want to continue to make progress in reducing cardiovascular disease, we have to address the onset of these risk factors in early life,” said Berry, who is calling for a greater focus on long term risks, especially for young people, who may have 40 or 50 more years to live. To see your long-term risk, you can use the Framingham 30-year risk calculator, though Berry believes we need an even longer risk projection for younger people.

So the overall message behind the study is, if you’re young, you have to do more to lower your risks or prevent risks altogether.

“We’re giving younger patients the wrong message by focusing on short term risks,” Berry said.

Laurie Tarkan is an award-winning health journalist whose work appears in the New York Times, among other national magazines and websites. She has authored several health books, including "Perfect Hormone Balance for Fertility." Follow her on Twitter and Facebook.