MAIN SESSION
INTERHEART -
for acute
a global study of risk factors myocardial 52
infarction in
countries
Munich, 29 August 2004 The aim of this main session was to present and discuss the results of the INTERHEART study, which was sponsored by the-World Health Organisation. The session was chaired by H. Tunstall-Pedoe (Dundee and Tadworth, UK) and J. Tuomilehto (Helsinki, Finland).
Firstly, S. Tusuf (Hamilton, Canada), the principal investigator of INTERHEART, presented the goals, design and general outcomes of the study. Although more than 80% of cardiovascular disease burden occurs in low and middle income countries, knowledge ofthe importance ofrisk factors is largely derived from developed countries. The aim of INTERHEART is to assess risk factors for cardiovascular disease globally, per region and for different ethnical groups. Secondly, the impact ofthese risk factors will be determined, again globally, per region and for ethnical groups. INTERHEART is a casecontrol study at 262 sites, in 52 countries from all continents. The study investigated 15,152 subjects who had suffered an acute myocardial infarction (AMI) and compared them with 14,820 ageand sex-matched controls. The distribution of cases and controls between geographical regions was representative for the total number of inhabitants within the region. Data were collected from questionnaires, physical measurements and blood samples. Nine easily measurable risk factors were assessed: ApoB/ApoA- 1 ratio,
smoking, diabetes, hypertension, abdominal obesity, stress, a lack of daily consumption of fruit and vegetables, alcohol consumption and daily physical exercise. Results are presented as relative risk and population-attributed risk (PAR). The Population Health Research Institute, Mc Master University, Canada, coordinated the study.
Overall, the median age for the first acute myocardial infarction (AMI) was 65 years in men, whereas women were 9 years older. However, in the Middle East, Africa and South East Asia first AMI occurs ten years earlier. There is a linear relation between an increasing ApoB/ApoA-l ratio and the risk for AMI. The ApoB/ApoA-1 ratio is the most important risk factor for AMI, closely followed by tobacco consumption and together these account for over two thirds of PAR. Not smoking, daily consumption of vegetables and daily exercise reduce cardiovascular disease risk by 80%. In Western Europe, 67% of AMI is related to adverse lifestyle, which is the highest percentage in the whole world. Globally, all nine risk factors together account for over 90% of PAR. As younger subjects (men 1 in men (women >0.95) is associated with a 2.53 higher risk compared with aVWHR
INTERHEART -
for acute
a global study of risk factors myocardial 52
infarction in
countries
Munich, 29 August 2004 The aim of this main session was to present and discuss the results of the INTERHEART study, which was sponsored by the-World Health Organisation. The session was chaired by H. Tunstall-Pedoe (Dundee and Tadworth, UK) and J. Tuomilehto (Helsinki, Finland).
Firstly, S. Tusuf (Hamilton, Canada), the principal investigator of INTERHEART, presented the goals, design and general outcomes of the study. Although more than 80% of cardiovascular disease burden occurs in low and middle income countries, knowledge ofthe importance ofrisk factors is largely derived from developed countries. The aim of INTERHEART is to assess risk factors for cardiovascular disease globally, per region and for different ethnical groups. Secondly, the impact ofthese risk factors will be determined, again globally, per region and for ethnical groups. INTERHEART is a casecontrol study at 262 sites, in 52 countries from all continents. The study investigated 15,152 subjects who had suffered an acute myocardial infarction (AMI) and compared them with 14,820 ageand sex-matched controls. The distribution of cases and controls between geographical regions was representative for the total number of inhabitants within the region. Data were collected from questionnaires, physical measurements and blood samples. Nine easily measurable risk factors were assessed: ApoB/ApoA- 1 ratio,
smoking, diabetes, hypertension, abdominal obesity, stress, a lack of daily consumption of fruit and vegetables, alcohol consumption and daily physical exercise. Results are presented as relative risk and population-attributed risk (PAR). The Population Health Research Institute, Mc Master University, Canada, coordinated the study.
Overall, the median age for the first acute myocardial infarction (AMI) was 65 years in men, whereas women were 9 years older. However, in the Middle East, Africa and South East Asia first AMI occurs ten years earlier. There is a linear relation between an increasing ApoB/ApoA-l ratio and the risk for AMI. The ApoB/ApoA-1 ratio is the most important risk factor for AMI, closely followed by tobacco consumption and together these account for over two thirds of PAR. Not smoking, daily consumption of vegetables and daily exercise reduce cardiovascular disease risk by 80%. In Western Europe, 67% of AMI is related to adverse lifestyle, which is the highest percentage in the whole world. Globally, all nine risk factors together account for over 90% of PAR. As younger subjects (men 1 in men (women >0.95) is associated with a 2.53 higher risk compared with aVWHR
