Cause of Most Heart Attacks Found

Aug. 30, 2004 (Munich, Germany) -- Heart researchers say nine risk factors -- ones that you can do something about -- account for 90% of all heart attacks.

Previously, researchers thought that only about half of heart attacks were explained by risk factors such as smoking or cholesterol. But now they say that the cause of almost all heart attacks can be pinpointed to one or more of the following:

• Smoking
• Abnormal cholesterol
• Diabetes
• High blood pressure
• Stress
• Abdominal obesity
• Sedentary lifestyle
• Eating too few fruits and vegetables
• Abstaining from alcohol

These risk factors are equal-opportunity killers -- black or white, Asian or American, young or old, man or woman -- all can fall victim by these same risks. Diet, exercise, and moderate consumption of alcohol can decrease risk of heart disease, but cannot reverse the potential danger posed by risks such as high cholesterol or smoking, says Salim Yusuf, MD, who led the study.

Studies have shown that men who drink up to two alcohol drinks a day and women who drink up to one a day have a lower risk of heart disease. One drink is generally considered to be four to five ounces of wine, a 12-ounce beer, or 1 ounce of liquor.

The study included nearly 30,000 people -- half were first heart attack survivors and half were healthy volunteers of similar age, race, and gender to the heart attack patients. Since the study was conducted in 52 countries located on every populated continent, Yusuf tells WebMD that it is now possible to say that "the same risk factor that causes a heart attack in a white European will cause a heart attack in an Asian."

Bigger Waist, Bigger Risk

Rather than relying on body mass index (BMI), the researchers took waist measurements. A waist circumference of more than 80 centimeters (32 inches) in women and more than 85 centimeters (34 inches) in men increased risk. Yusuf says measuring the waist is a better predictor of heart attack risk because "it is a measure of abdominal fat, which is the type of fat that is most closely associated with heart attacks."