A continuation of my INTERHEART study post:
Researchers found that smoking only 1 to 5 cigarettes a day increased the risk of heart attack by about 40%, a pack/day quadrupled the risk, and 2 packs a day increased the risk by a factor of 9 (900%). According to this graph, there is no threshold, or no point at which smoking more will not continue to increase risk. If there could be a bright side to this finding, it's that, if you smoke and are finding it difficult to quit, decreasing the number can at least decrease your risk proportionately.
Smoking was found to be such a powerful predictor of a heart attack that, according to Medscape, even if you puff on just 1 to 5 a day, "it could eliminate as much as 75% of the benefit of taking a statin." That's like throwing money out the window. Actually, it's like making tobacco and pharmaceutical companies richer at the expense of a few years of your life.
Combining Risk Factors
From the study:
"Incorporation of all nine independent risk factors (current or former smoking, history of diabetes or hypertension, abdominal obesity, combined psychosocial stressors, irregular consumption of fruits and vegetables, no alcohol intake, avoidance of any regular exercise, and raised plasma lipids) indicates an odds ratio of 129•20. [Using the extremes] increases the combined effect of all nine risk factors to 333•7."So, if your only vice was to smoke a pack of cigarettes a day, your heart attack risk might be 4 times greater than if you didn't smoke. But smoke, shun fruit/vegs, shun exercise, carry a midsection, suffer high blood pressure, etc., and you could be 334 times (33,370%) more likely to experience heart failure. That's mighty predictive if you ask me.
This one surprised me. I thought genes would play a larger role. According to INTERHEART, 90.4% of heart attacks can be attributed to one of the 9 factors mentioned; that rises to only 91.4% when you factor in family history. So you may be born with a predisposition, but how you live your life will ultimately govern your heart health.
BMI vs. Waist-to-Hip
These are 2 popular anthropometric measurements used in nutrition. I never thought BMI (Body Mass Index) would catch on, but I hear "I'm down to 28, what's yours?" and "30!! Get out!!" more often. But BMI was never good at accounting for lean mass/fat mass or distribution of weight on a frame. A bodybuilder who is relatively short, albeit fat-free (not pictured), might meter in with a BMI of "morbidly obese". Maybe that's why BMI proved not as significant as the unglamorous waist-to-hip ratio in predicting a heart attack. If your waist measurement exceeds your hip measurement, it might not be a bad idea to stop reading right now and take the dog for a walk.
Photo by Robert Browne.
* FRE: Fanatic's Resident Eater