Unexpected factors that affect CV risk

By Liz Meszaros, MDLinx
Published October 29, 2019

Key Takeaways

These days, it seems that researchers uncover new associations and risks for different diseases daily. So, to keep you au courant, MDLinx has compiled a list of the latest findings on cardiovascular (CV) risks and disease. There are a few surprising factors that may affect your CV risks—for both better and worse.

Changes in household income. You probably didn’t realize that your income could directly affect your cardiovascular risk. In fact, it can, according to researchers who analyzed data from the Atherosclerosis Risk In Communities (ARIC) study—an ongoing study in almost 16,000 community-dwelling individuals begun in 1987. A drop in income of more than 50% over 6 years was associated with a 17% higher risk of CVD over the next 17 years (HR: 1.17), whereas a rise in income of more than 50%was associated with a 14% lower risk of CVD (HR: 0.86). Researchers called for clinicians to be more aware of the great influence that changes in income can have on CV health.

Early menopause. Age at menopause may be a good predictor of a woman’s risk for CVD. According to results of a study published in The Lancet Public Health, women who reach menopause before age 50 may be at increased risk for CV disease. Researchers from the University of Queensland, Brisbane, Australia, included 301,438 women, of whom 4.3% had a first non-fatal CVD event after menopause (3.1% coronary artery disease; 1.4% stroke).

Women who experienced premature menopause—at less than 40 years of age—had a higher risk of CVD (HR: 1.55; P < 0.0001) compared with those who underwent menopause between ages 50-51 years. The same was true in women who experienced early menopause between ages 40-44 years (HR: 1.30; P < 0.0001), and relatively early menopause between ages 45-49 years (HR: 1.12; P < 0.0001).

Less than 6 hours of sleep per night. In middle-aged adults who have hypertension or type 2 diabetes, the risks of CVD and stroke mortality are increased two-fold if they sleep for less than 6 hours per night, according to a study published in the Journal of the American Heart Association.

Researchers studied 1,654 adults from the Penn State Adult Cohort (mean age: 47.5 years; 52.5% women; 89.8% white) in whom cause of death was determined after 19.2 years. All-cause mortality risks associated with cardiometabolic risk factors and cardiovascular and cerebrovascular diseases were significantly higher in those who slept less than 6 hours (HR: 2.14 and 3.17, respectively). Also, in those who slept less than 6 hours per night, cardiometabolic risk factors were associated with a 1.83 higher risk of CVD mortality and cardiovascular and cerebrovascular disease, as well as a 2.92 higher risk of death from cancer.

In those who slept 6 hours or more per night, researchers found no significant association between cardiometabolic risk factors and CBVD mortality, nor an association between cardiovascular and cerebrovascular diseases and cancer mortality.

FGF23 levels in diabetics. Fibroblast growth factor 23 (FGF23) is a protein necessary for regulating phosphate homeostasis, and its levels in the body are controlled largely by the kidneys. Thus, it is not surprising that in patients with type 2 diabetes and normal or mildly impaired kidney function, FGF23 is associated with increased risks of CV events and mortality.

In this study, researchers included 310 patients with type 2 diabetes and estimated glomerular filtration rates of 60 mL/min/1.73 m2 or more. After a follow-up of 5.8 years, they found that FGF23 was associated with an increased risk of all-cause mortality (HR: 2.78) and major adverse cardiovascular events (HR: 1.67), even after adjusted analysis.

Now, here are a few of the factors—some surprising—that may improve your cardiovascular status and reduce risks:

Your mindset. Whether you’re aware of it or not, your frame of mind can have a powerful effect on your health. And, in this meta-analysis, researchers proved it. They analyzed data from 15 studies that included nearly 230,000 individuals and found that optimism was associated with a lower risk of CV events (RR: 0.65; 95% CI: 0.51-0.78; P < 0.001), while pessimism was associated with a higher risk of CV events. Optimism was also significantly associated with a lower risk of all-cause mortality (RR: 0.86; 95% CI: 0.80-0.92; P < 0.001). Basically, the most optimistic people were a full 14% less likely to die from any cause, and 35% less likely to experience CV events compared with the least optimistic people. The take-home message? Always look on the bright side.

Later menopause. Surprisingly, in one of the previous studies above, the researchers for the University of Queensland also found that women who experienced menopause after the age of 51 years had a significantly reduced risk of CVD (P < 0.0001 for trend). Further, the risk for CVD was strongest for women with premature menopause and early menopause before they reached the age of 60 years, but was mitigated between ages 60-69, and gone at age 70 years and older.

A high-fiber diet. In those with hypertension and type 2 diabetes, a diet that is high in fiber and with a low-glycemic index may significantly protect against CVD and reduce CV risk, according to results presented at the American College of Cardiology Middle East Conference.  Specifically, a high-fiber, low-glycemic index diet significantly improved both brachial-ankle pulse wave velocity (P < 0.0001), systolic BP (P < 0.0068), and diastolic BP (P < 0.0001). Such a diet also improved serum cholesterol (P < 0.0001), LDL levels (P < 0.0001), and waist-to-hip ratio (P < 0.0001).

Those with diabetes also demonstrated significant improvements in HbA1c (P = 0.0001) and fasting glucose levels (P = 0.0017).

In addition, high-fiber diets have also been shown to significantly lower the risk of mortality and non-communicable diseases, including coronary heart disease, stroke, type 2 diabetes, and colorectal cancer.

Be aware of the little things in life that could affect your CV risk. Some may be out of your control, but a few are very modifiable—such as mindset and diet. Look to these and change them for the better.

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