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"The causes of heart disease are surprisingly the same in every region and 
race, and stress seems to play a more important role in heart attacks than 
previously recognized, a major new study has found. Nearly all of what is 
known about the causes of heart disease comes from studies of white people 
in rich countries, because that's where the illness first emerged. However, 
with the globe's No. 1 killer now taking over the developing world as well, 
scientists have been worried that the way it is tackled in the West - by 
combatting smoking, obesity, blood pressure and cholesterol, among other 
things - may not necessarily apply in poorer countries. 'Some 80 percent of 
the heart disease in the world is in developing countries, yet 99 percent of 
the research done into the causes of heart disease comes from developed 
countries and largely white, European populations, so we really don't know 
for sure whether we can apply the results of the studies we've got to the 
rest of the world,' said the study's leader, Dr. Salim Yousef, a professor 
of medicine at McMaster University in Canada, explaining what prompted the 
study." - Source
http://apnews.myway.com/article/20040830/D84P88EO0.html


Heart Disease Causes Seen Same Worldwide
Aug 29, 9:34 PM (ET)
By EMMA ROSS


MUNICH, Germany (AP) - The causes of heart disease are surprisingly the same 
in every region and race, and stress seems to play a more important role in 
heart attacks than previously recognized, a major new study has found.

Nearly all of what is known about the causes of heart disease comes from 
studies of white people in rich countries, because that's where the illness 
first emerged.

However, with the globe's No. 1 killer now taking over the developing world 
as well, scientists have been worried that the way it is tackled in the West 
- by combatting smoking, obesity, blood pressure and cholesterol, among 
other things - may not necessarily apply in poorer countries.

"Some 80 percent of the heart disease in the world is in developing 
countries, yet 99 percent of the research done into the causes of heart 
disease comes from developed countries and largely white, European 
populations, so we really don't know for sure whether we can apply the 
results of the studies we've got to the rest of the world," said the study's 
leader, Dr. Salim Yousef, a professor of medicine at McMaster University in 
Canada, explaining what prompted the study.

The research, presented Sunday at the annual meeting of the European Society 
of Cardiology, followed 29,000 people in 52 countries. It took a decade and 
262 scientists to complete the work, which, according to the editor of The 
Lancet medical journal, is probably the most robust study on heart disease 
risk factors ever conducted.

The scientists, who concluded that about 90 percent of the risk factors for 
heart attacks can be prevented, are scheduled to published the findings in 
The Lancet next week.

"This study confirms that the risk factors are the same all over the planet 
and ... has made it possible to assess the weight of the different risk 
factors," said Dr. Jean-Pierre Bassand, president of the European Society of 
Cardiology. "It's a fantastic study.

"It is clear that not a single continent, not a single civilization, not a 
single race, can be spared from cardiovascular disease, which will hit 
humankind more dangerously than the Black Death in the Middle Ages," said 
Bassand, who was not connected with the study or the publication. "What we 
need is political action."

The study examined 15,000 people who had suffered their first heart attacks 
and matched them with someone of the same age, sex and location who had not 
had a heart attack.

A bad cholesterol profile, measured using a new test considered better than 
the standard one that looks at the balance between good HDL cholesterol and 
bad LDL cholesterol, was the most important risk factor.

Smoking was the next most important player, followed by diabetes, high blood 
pressure and a fat belly.

Stress came next, followed by inadequate fruit and vegetable intake, then 
lack of exercise. Light to moderate alcohol consumption was found to be of 
slight benefit.

Yousef said he was surprised by some of the findings.

"My expectation when I went into this was that I would find ethnic and 
regional variations, because some of our earlier papers had suggested that. 
It just shows you need massive numbers to get the right answer," Yousef 
said. "I thought smoking would be bad everywhere, but the (cholesterol) I 
wasn't sure."

But what was most unexpected, he said, was the power of stress.

"The standard biomedical scientist is really not interested in stress, 
partly because they are uncomfortable with the concept, the certain softness 
with which you measure it," Yousef said. "I came into this with a little 
educated hostility regarding stress, but I've changed my mind after seeing 
the data."

The problem is psychological, not physical, stress - things such as tension 
at home or at work, financial problems, divorce, losing a child, or feeling 
of loss of control.

Most experts believe that about half of the risk of a heart attack can be 
prevented. The latest study, however, indicated that about 90 percent of the 
causes of heart attacks can be averted.

The study indicated that about 50 percent of the chance of having a heart 
attack comes from a bad cholesterol profile alone, Yousef said.

"Globally, in urban populations, there's practically nobody with a level of 
(cholesterol) that avoids an increased risk of heart disease," he said.

Smoking is responsible for another 36 percent of the risk, the study found.

"The impact of these risk factors was the same in every ethnic group and in 
every region of the world," Yousef added. "That means preventive messages 
can be simple and we can use the same strategy, of course adjusted for 
economic and cultural circumstances, in every part of the world."

The difference between men and women seen in the West was also observed all 
over the world. Men usually get heart attacks at about 57, women at 65.

Although that sex difference held true everywhere, the study found that in 
southern Asia, the Middle East and Africa, people suffer heart attacks about 
10 years earlier.

The study implies that the main way to tackle the problem is societal 
change, including better urban planning and health-promoting food policies 
and advertising regulations, experts said.

The study comes on the heels of a World Health Organization vote in May to 
implement a global strategy on diet and exercise aimed at combatting 
obesity, diabetes, heart disease and other illness linked to an unhealthy 
lifestyle.

_________________________________________________________________
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