Controlling high blood pressure, hyperlipidemia (known as high cholesterol), diabetes, obesity or overweight, and smoking extends life by up to 14 years, according to a study published in the New England Journal of Medicine. According to the researchers, the absence of these indicators is associated with an additional 13.3 years free of cardiovascular disease for women and 10.6 years for men.
The five controllable factors identified by the study are responsible for nearly 50% of the global risk of cardiovascular disease, common among people over 50 years of age. If habits that combat the development of these conditions are adopted in middle age – from the age of 40 – it is possible to increase average lifespan by up to 14.5 years for women and 11.8 years for men.
The results showed that behavioral change between the ages of 55 and 60 generates the greatest benefit. Controlling high blood pressure in this range gives the greatest increase in the period in which there is no cardiovascular disease, and stopping smoking prolongs death by more years. The absence of diabetes indicated a difference of 6.4 years for women and 5.8 for men, while not smoking had an effect of 5.6 years for women and 5.1 for men.
The scientists, led by the University of Hamburg, collected data from more than two million participants in 39 countries across six continents. “The diversity of contexts and cultures is key because it reflects a more realistic and comprehensive risk. This means that the data represent different groups and realities,” explains Professor of Medicine at UPF (University of Passo Fundo) and one of the authors of the article, Karen Oppermann. “This variability gives the study much greater power and precision, making the results particularly important for understanding the impact of risk factors in the real world.”
The patients include 350 postmenopausal women from Passo Fundo and 1,700 people monitored by the UFSC (Federal University of Santa Catarina). This information was provided to EpiFloripa (Health conditions of adults and the elderly in Florianópolis).
The results are relevant to population health. If there is a behavioral change in an individual, it does not mean that he will live exactly 14 more years, it could be more or he could have a heart attack without any of the five risk criteria.
The state must work to mitigate the factors, says Eleonora Dorsey, a professor in the Department of Public Health at UFSC and one of the authors of the article. Cardiovascular diseases are the leading cause of death in the world, according to the World Health Organization.
“All the agents have public policies that are implemented and operated by the unified health system,” he says. “I don’t think there is another country that has these policies in this systematic way, even Canada and England, which have a public health system.”
She cites the Brazilian war against smoking as an example. “Brazil has the most successful policy to reduce smoking in public places.” Moreover, there are protocols to combat high blood pressure that even include changes in behavior and diet and “affect other risk factors, such as obesity and diabetes for example.” He says the presence of street gyms and physical education teachers is also important.
“These are simple initiatives, but they require trained professionals engaged in this great mission of reducing cardiovascular risk – the leading cause of death among men and women,” Opperman says.
Social and economic factors are associated with the development of diseases. This is because the poorest populations tend, for example, to consume more ultra-processed foods, according to a study conducted by the University of São Paulo School of Medicine in 2022. Consumption of these products is linked to the risk of developing four of the factors, as several studies have shown in recent years.
“Numerous studies show that social inequality – such as income, quality of housing, employment, transportation, and access to health care and services – has a significant impact on the prevalence of risk factors.”
However, Dorsey says the results are hopeful because they mean those who kick bad habits after age 50 still have a chance to regain years of life.
As for smoking, the rule is clear: don’t smoke. There is no safe amount of cigarettes, according to a study conducted by the US National Cancer Institute and published in 2017 in the journal Jama International Medicine. Even those who smoke once a day – or less – have a chance of early death. In addition to cardiovascular diseases, substances in cigarettes promote other diseases, such as lung cancer, emphysema, and others.
UFSC Department of Physiology professor Jamaira Victorio, who was not part of the study, says the breadth of data can affect the accuracy of the results, including due to unequal information coming from different regions, causing a lack of information. It’s part of it, even more so when the investigation is global. “Interestingly, the work brings together all the information using statistical modeling to compare the data.”
However, he considers the result “exciting”, and says that in addition to changing habits after the age of 50, the state and parents should use the results with the aim of preparing young people for old age.
UPF’s Oppermann says the project will move to a new phase, which will include new variables.
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