Controlling modifiable risk factors, like smoking

Controlling modifiable risk factors, like smoking

Controlling modifiable risk factors, like smoking habits, weight, hypertension, and diabetes, can increase life span, according to new research. Those same risk factors can greatly improve heart health and reduce problems like heart attack.

A healthy lifestyle during the early elderly years—including weight management, exercising regularly and not smoking—may be associated with a greater probability of living to age 90 in men, as well as good health and physical function, according to a report in the February 11 issue of Archives of Internal Medicine.

Studies of twins have found that about one-fourth of the variation in human life span can be attributed to genetics, according to background information in the article. That leaves about 75 percent that could be attributed to modifiable risk factors. Those modifiable risk factors are also key to maintaining a healthy heart.

Laurel B. Yates, M.D., M.P.H., of Brigham & Women’s Hospital, Boston, and colleagues studied a group of 2,357 men who were participants in the Physician’s Health Study. At the beginning of the study, in 1981 to 1984, the men (average age 72) provided information about demographic and health variables, including height, weight, blood pressure and cholesterol levels and how often they exercised. Twice during the first year and then once each following year through 2006, they completed a questionnaire asking about changes in habits, health status or ability to do daily tasks.

A total of 970 men (41 percent) lived to age 90 or older. Several modifiable biological and behavioral factors were associated with survival to this exceptional age. “Smoking, diabetes, obesity, and hypertension significantly reduced the likelihood of a 90-year life span, while regular vigorous exercise substantially improved it,” the authors write. “Furthermore, men with a life span of 90 or more years also had better physical function, mental well-being, and self-perceived health in late life compared with men who died at a younger age. Adverse factors associated with reduced longevity—smoking, obesity, and sedentary lifestyle—also were significantly associated with poorer functional status in elderly years.”

The researchers estimate that a 70-year-old man who did not smoke and had normal blood pressure and weight, no diabetes and exercised two to four times per week had a 54 percent probability of living to age 90. However, if he had adverse factors, his probability of living to age 90 was reduced to the following amount:

  • Sedentary lifestyle, 44 percent
  • Hypertension (high blood pressure), 36 percent
  • Obesity, 26 percent
  • Smoking, 22 percent
  • Three factors, such as sedentary lifestyle, obesity and diabetes, 14 percent
  • Five factors, 4 percent

“Although the impact of certain midlife mortality [death] risks in elderly years is controversial, our study suggests that many remain important, at least among men,” the authors conclude. “Thus, our results suggest that healthy lifestyle and risk management should be continued in elderly years to reduce mortality and disability.”

Archives of Internal Medicine 2008

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