Page 20 - SEPTEMBER 2017 B ISSUE

20 www.hello-philippines.com HEALTH and Lifestyle September 2017 / Fortnightly – No. 18 • UK & Europe Edition

LACK OF EXERCISE ‘HIGHEST RISK’ FOR WOMEN OVER 30
“HEART disease warning: Lack University of Queensland in Australia. use these figures to help them decide health priority for women than they are
now, across the adult lifespan.”
of exercise is worse risk for over-30s Some of the data came from which risk factors they should be
Conclusion. This study has
women than smoking or obesity,” The the Australian Longitudinal Study targeting to get the greatest reduction found that the proportion of heart
disease attributable to four risk factors
Independent reports. It is important to on Women’s Health, funded by the in disease in the population as a whole. (smoking, high BMI, high blood
What did the research involve? pressure and physical inactivity) in
stress that this headline is based on a Australian Department of Health. One Australian women changes with age.

result that is applicable to a population, of the researchers was supported by the The researchers calculated population The figures calculated in this
study—called population attributable
not to an individual. Australian National Health and Medical attributable risk for heart disease that risk—indicate the proportion of cases
Exercise is important for women Research Council. was attributable to four risk factors: that would not occur in a population if
risk factors were eliminated. Population
of all ages. The Australian study the The study was published in the peer- •high body mass index (BMI) attributable risk depends on the increase
in risk of heart disease associated with
headline is reporting on looked at reviewed British Journal of Sports •smoking the factor, and the number of women
with the risk factor.
population attributable risk, or PARs. Medicine. •high blood pressure
A risk factor could have the highest
PARs can be used to estimate the The results of the study were •physical inactivity Women’s Health between 1999 and population attributable risk if it is
the most common risk factor in a
proportion of cases of a disease, such as reported well by BBC News and The To do this, they used relative risks of 2012. This study surveyed women born population. But this is not necessarily
because it is associated with the greatest
heart disease, that would not occur in Daily Telegraph. However, the Daily heart disease associated with high from 1973-78 (the younger cohort), increase in risk for the individual.

a population if the risk factor, such as Mail has misinterpreted the meaning BMI, smoking, high blood pressure 1946-51 (the mid-aged cohort), and This study has found that smoking
had the highest population attributable
inactivity, was eliminated. of the figures reported in the study— and physical activity from the Global 1921-26 (the older cohort) every three risk in women under 30. If women
in this age group gave up smoking,
The researchers wanted to determine specifically, how the population Burden of Disease reports. years. approximately 55-60% of cases of
heart disease would be estimated to be
the proportion of heart disease that was attributable risk tool “works”. The relative risks give a measure of The risk factors were defined as: eliminated.

attributable to four specific risk factors: It reports that individual women the strength of the association between •high BMI (>23kg/m2) In women aged 30 or over, physical
inactivity (low or no physical activity)
smoking, physical inactivity, high body in their thirties who are inactive are each risk factor and heart disease. The •current smoking had the highest population attributable
risk of the four factors assessed.
mass index, and high blood pressure. almost 50% more likely to develop Global Burden of Disease reported •high blood pressure (defined If inactive women aged 31 to 36
increased their physical activity, about
They looked at groups of women of heart disease. However, the study refers relative risks based on pooling of results as being diagnosed or treated for 51% of cases of heart disease could be
eliminated.
different ages. to outcomes at the population level. (meta-analyses) of epidemiological hypertension)
The population attributable risk
Two key findings of the study were The 50% figure actually refers to studies. •no or low physical activity (defined for inactivity was lower in older age
groups, but if women aged 47 to 64
that: the proportion of heart disease cases As the risk associated with risk by the Global Burden of Disease increased their physical activity, 33% of
heart disease cases could be eliminated.
•smoking had the greatest PAR in that could be eliminated from the factors varies by age and with sex, study) – MET minutes per week were If women aged 73 to 90 did the same,
24% of heart disease cases could be
women under 30 – if women aged under population as a whole if this inactivity the researchers used relative risks calculated from reported time spent eliminated.

30 gave up smoking, approximately 55- was not present. specifically for women and the age walking briskly and in moderate and One important factor to note is
that these population attributable risk
60% of cases of heart disease would be It could be the case that eliminating groups they were looking at. vigorous leisure time activities figures are estimates designed to give
an indication of the maximum effect
eliminated a risk factor reduces the number of Relative risks in the Global Burden The researchers used the relative that might be achieved by removing
these risk factors. Achieving this change
•physical activity had the greatest cases the most because it is the most of Disease reports compared the risk of risks and prevalence estimates to may be difficult.

PAR in women aged 31 and older – if common risk factor in a population, heart disease for: calculate population attributable risks The estimates also do not take into
account interactions between these and
women aged 31 to 36 increased their rather than because it is associated •high BMI (>23kg/m2) versus low using standard methods. other risk factors. They therefore may
What were the basic results? The overestimate the impact of each factor
physical activity, about 51% of cases of with the greatest increase in risk for the BMI (23kg/m2) individually.

heart disease could be eliminated individual. •current smokers versus non- risk of heart disease associated with As population attributable factors
What kind of research was this? smokers take into account the prevalence of risk
It pays to emphasise that factors each risk factor varied across age factors, they will also change depending
on how common a risk factor is, and will
could have the greatest PAR simply This was an analysis of data from cohort •high blood pressure (>115mmHg groups, as did the prevalence of each therefore differ across populations with
different behaviours and characteristics.
because they are the most common, studies. It aimed to determine the average) versus low blood pressure risk factor.
Overall, the findings of this study do
rather than because they are associated proportion of heart disease attributable (<115mmHg average) Smoking was associated with the not change the message for individuals
about the importance of reducing
with the greatest increase in risk for to four specific risk factors in Australian •no, low and moderate physical greatest increase in risk of heart disease unhealthy behaviours such as smoking,
and making sure we stay active.
the individual. In fact, smoking was women of different ages. activity versus high physical activity at all ages. Of the four factors assessed,
If you are concerned about your
associated with the greatest increase in The figure the researchers were The latter was assessed using what is smoking had the highest population fitness level, why not try the NHS
fitness plan, which is designed to get
risk of heart disease at all ages. calculating is called population known as MET (metabolic equivalents), attributable risk in women aged 22 to fitness phobes up to speed in 12 weeks.

It would be unwise to think you attributable risk, or PAR. It indicates a calculation of how much energy is 27 (59%) and 25 to 30 (56.6%). n NHS Choices

could offset one risk against another. the proportion of cases of a disease burned off over a minute during certain The population attributable risk

Just because you take regular exercise that would not occur in a population activities. For example, for most people, associated with smoking was lower in

does not mean that it is safe for you to if a risk factor was eliminated. PAR running at 10 mph is equal to 16 METs. women aged 47 to 64 and in the older

smoke. depends on how common a risk factor The researchers used estimates of cohort, and was 5% in women aged 73
Where did the story come from? The is (its prevalence) and the strength of its how common each risk factor was to 78 (the oldest group of women with

study was carried out by researchers association with the disease. (prevalence) in Australian women from smoking data available).

from the University of Sydney and the Researchers and policy makers can the Australian Longitudinal Study on In women aged 31 to 90, physical

Symptoms of high blood pressure inactivity (no or low physical activity)
had the highest population attributable
risk of the four factors assessed. The
population attributable risk of physical
HIGH blood pressure (hypertension) •shortness of breath risk of developing pregnancy-induced inactivity in women aged 31 to 36 was
50.9%.
usually has no obvious symptoms and Pregnancy. If you are pregnant, it’s hypertension.
On average, the population
many people have it without knowing. important to have your blood pressure This can lead to a serious condition
Untreated high blood pressure checked on a regular basis, even if it isn’t called pre-eclampsia where there is a attributable risk was:
•48% in the younger cohort (aged
can lead to serious diseases, high. problem with the placenta (the organ
Watching your blood pressure that links the baby’s blood supply to the 22 to 39)
including stroke, heart disease and kidney •33% in the mid-aged cohort (aged

failure. while you are pregnant reduces your mother’s). n NHS Choices 47 to 64)

The only way to know if you have high •24% in the older cohort (aged 73

blood pressure is to have your blood to 90)
How did the researchers interpret
pressure measured. All adults should
get their blood pressure checked at least the results? The researchers concluded
once every five years.
that, “From about age 30, the population
In some rare cases, where a person
risk of heart disease attributable to
has very high blood pressure, they can
inactivity outweighs that for other risk
experience symptoms, including:
factors, including high BMI.
•a persistent headache
“Programmes for the promotion
•blurred or double vision
and maintenance of physical activity
•nosebleeds
deserve to be a much higher public