Lifestyle Risks, Cardiovascular Calcium, Events and Mortality eInterview with: Haitham Ahmed, MD, MPH

The Ciccarone Center for the Prevention of Heart Disease
Johns Hopkins Hospital What were the main findings of the study?

Dr. Ahmed: Everyone knows that healthy lifestyle habits are major factors that protect you from heart disease. What we don’t know is which habits are most important, and how exactly these habits prevent disease progression along the causal biological pathway over years and years. So we followed 6,200 men and women of various ethnic backgrounds from 6 university locations across the US. We looked at their eating habits, exercise, weight, and smoking history. We did CT scans on them at the start of the study and then a few years later (mean 3 years) and found that healthier people had lower calcium deposition in their coronaries. We then kept following them and found that these same healthy people had a trend towards less cardiovascular events. We then kept following them further and found that these same healthy people died less, by an 80% lower rate, compared to people that were unhealthy, which was incredible. So what we took away from this is that you have enormous power in changing your risk of atherosclerosis, heart disease, and death by changing your lifestyle behaviors. Where any of the findings unexpected?

Dr. Ahmed: Yes, several of the findings were unexpected and novel:

1) This is the first study to look at biological progression every step of the way in a single longitudinal fashion. We looked at people’s coronaries (via CT) before they started, saw how healthy participants were based on exercise, diet, weight, smoking, looked at their coronaries again a few years later to see the effects of subclinical atherosclerosis, then looked a few years later to see how many had real cardiovascular events, then looked a few years later to see how many had died. No prior studies have ever looked at this in a causal pattern so our findings really add biological credibility to the conclusions made.

2) The benefits were cumulative, meaning the more healthy behaviors the better. So if you maintained a normal weight and ate healthy but weren’t exercising, this shows you can still have even more benefit from adding exercise to your life.

3) We found that smoking was clearly the worst behavior of the ones we investigated. In fact, if you exercised, ate healthy, and maintained normal weight, but smoked; you still were worse off then people who did nothing else right but stayed away from cigarettes. This really highlighted how important it is to stay away from smoking; it is probably single-handedly the best thing you can do for your cardiovascular and overall health.

4) Most importantly, all the factors we looked at are things you can change. You can’t pick your family history or change your age, but you can start exercising today, and you can start changing your diet today. All these interventions are things that cost us very little to nothing and are 100% in our hands. Our patients have the ability to control their own wellness and health. What should clinicians and patients take away from your report?

Dr. Ahmed: All the variables we investigated are things that cost you very little to nothing to change and are 100% in your hands. You cannot change your family history or your age, but you can begin exercising and change your diet today. You have the ability to control your own wellness and health. And it’s never too late to start.


Low-Risk Lifestyle, Coronary Calcium, Cardiovascular Events, and Mortality: Results From MESA

Haitham M. Ahmed, Michael J. Blaha, Khurram Nasir, Steven R. Jones, Juan J. Rivera, Arthur Agatston, Ron Blankstein, Nathan D. Wong, Susan Lakoski, Matthew J. Budoff, Gregory L. Burke, Christopher T. Sibley, Pamela Ouyang, and Roger S. Blumenthal

Last Updated on June 4, 2013 by Marie Benz MD FAAD