Five points
The risk of atherosclerosis can be predicted without taking tests
Researchers from Spain compared two ways to assess the likelihood of atherosclerosis and found that the simpler one works just as well as the more complex one.
Cardiovascular diseases are the main cause of death worldwide. For their successful prevention, a good understanding of risk factors and the development of indicators to assess the overall likelihood of the disease are necessary.
In 2010, the American Heart Association proposed using the so-called "ideal cardiovascular health score" (ICHS – ideal cardiovascular health score) for this. This is an integral indicator that includes information about seven factors: smoking, body mass index, physical activity level, diet, blood pressure and cholesterol and blood sugar levels.
However, along with ICHS, other indicators have been developed, in particular a simpler Fuster-BEWAT, named after five factors included in it (pressure – Blood pressure, physical activity – Exercise, weight – Weight, nutrition – Alimentation and smoking – Tobacco). It does not require testing for cholesterol and sugar, and therefore is much more convenient to use. But does not a smaller number of factors mean that he assesses the state of health worse?
A team of scientists from the Carlos III National Center for the Study of Cardiovascular Diseases (CNIC) in Madrid decided to answer this question. To do this, they studied the health status of 3,983 men and women from the PESA cohort, consisting of employees of Madrid-based Banco Santander, aged 40 to 54 years, who did not have cardiovascular diseases.
The study participants underwent a full clinical examination, an ECG, passed blood and urine tests and answered questionnaires about their lifestyle. Checking for the presence of subclinical atherosclerosis was carried out using various medical methods, such as computed tomography.
Based on these data, ICHS and Fuster-BEWAT were calculated, which were then compared with information about the state of the vessels. As a result, it was found that both indicators predict the risk of subclinical atherosclerosis equally well. Poor indicators are likely to indicate the presence of the disease (only 18.8% of people with bad ICHS and 20.5% with bad Fuster-BEWAT were completely free of it).
On the other hand, even ideal indicators do not guarantee health – signs of the disease were found in almost half of those studied with ideal indicators. Perhaps the indicators affect the rate of development of the disease. Further studies of the PESA cohort should confirm this assumption.
In addition, the study helped to understand which factors its participants are OK with, and which ones they are experiencing problems with. In particular, it turned out that women in general monitor their health more and their indicators are better. The Spaniards are doing best with physical activity, and worst of all with the diet.
The transition to more active use of the Fuster-BEWAT indicator will make the diagnosis of atherosclerosis in the early stages more effective and simplify self-monitoring of lifestyle.
The study was published in the Journal of the American College of Cardiology (Fernández-Alvira et al., Predicting Subclinical Atherosclerosis in Low-Risk Individuals).
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