Oxford Population Health researchers have shown that known risk factors for heart disease remain strong predictors of life expectancy and risk of death from heart disease and stroke throughout the lifespan. People with the lowest risk factors for heart disease are likely to live 12 years longer after age 50 compared to people with higher risk factors. This study public health.

It has long been known that people who smoke cigarettes, have high blood pressure, high total cholesterol levels, or diabetes have a much higher risk of developing heart disease. In recent decades, the number of smokers and people with these common risk factors has decreased, and life expectancy for many people has increased. With more people now living over 80 than ever before, is recording these risk factors in midlife still relevant for predicting risk of death from heart disease and stroke in old age? Some people have doubts.

To find out, researchers looked at data collected from 19,019 male civil servants who worked in London between 1967 and 1970 who took part in the Whitehall Study. Participants’ ages ranged from 40 to 69 years at the time of enrollment. The researchers were able to record risk factors for heart disease using a questionnaire and simple clinical measurements (blood pressure, height, weight) and the collection of blood samples (cholesterol and blood sugar levels).

The surviving participants were resurveyed in 1997 and provided data on their levels of heart disease risk factors in middle age and old age. Study participants were then followed for 50 years to determine when they finally died, and if they did, the date and cause of death were recorded.

Key findings:

• By July 1, 2000, 97% (17,673 people) of participants had died. 22% of participants died before age 70, 51% died before age 80, and 80% died before age 90.
• Of the 17,673 participants who died by 2000, 45% (7,944 people) died of heart disease or stroke.
• Participants with the lowest number of risk factors for heart disease had a less than 1% risk of dying from heart disease within 10 years and a 31% risk of ultimately dying from heart disease.
• Participants with the highest number of heart disease risk factors had a 10% risk of dying from heart disease within 10 years and a 61% risk of ultimately dying from heart disease.
• Participants with the fewest number of risk factors had a life expectancy of 12 years longer after age 50 than those with the highest number of risk factors.

Professor Robert Clarke, emeritus professor of epidemiology and public health medicine at Oxford Population Health, said: “The Whitehall study began at the peak of the UK heart disease-related death epidemic in the 1970s. This research provides a unique opportunity to examine data collected over a lifetime, and is a precursor to work such as UK Biobank and China Kadoorie Biobank, which are answering today’s most pressing health questions. The results of the Whitehall study show that smoking, high blood pressure, elevated cholesterol levels and diabetes still put people at risk of developing heart disease and dying prematurely. They support current health policies that encourage smoking cessation, maintaining a healthy lifestyle, and lowering blood pressure and cholesterol levels. ”