During my lectures, I frequently ask, "What is the most common symptom of heart disease?" Very few are able to answer correctly. Most guess chest pain or shortness of breath, but the actual answer is far more obvious: sudden death. While fish and cod liver oil are one of the best ways to prevent heart disease and sudden death, other factors are just as significant.

In fact, the INTERHEART study, a major global project led by a group of Canadian researchers, has found nine easily measurable factors can predict the vast majority of heart attacks. What may surprise you: These markers are the same in virtually every region and ethnic group worldwide. The INTERHEART study looked at more than 29,000 people in 52 countries and from all inhabited continents of the world.

The two most important risk factors--cigarette smoking and an abnormal ratio of blood lipids (Apolipoprotein B/Apolipoprotein A-1)--account for two-thirds of the predicted global risk of heart attack. The rest of the list:

• High blood pressure
• Diabetes
• Abdominal obesity
• Stress
• A diet lacking in fruits
• Not eating enough vegetables
• No daily exercise

Worldwide, these nine factors collectively predict more than 90 percent of the risk of a heart attack. What the study did not look at though, and are likely even more powerful influences of heart disease are:

• Unresolved emotional stress
• Elevated insulin level
• Decreased dietary omega-3 fats
• Decreasd sun exposure resulting in lower vitamin D

EurekAlert August 29, 2004