Roundup: At Least One ‘Non-Optimal’ Risk Factor Precedes Nearly All Cardiovascular Events; and More News

Nearly Everyone has at Least One Modifiable Risk Factor Before Cardiovascular Event, New Study Finds

Almost every individual who experiences a major cardiovascular event, such as heart attacks, strokes, or heart failure, carries at least one risk factor — such as high blood pressure —  that may not prompt a formal medical diagnosis, according to a new study published in the Journal of the American College of Cardiology.

This research, conducted by a team of Korean and U.S. scientists, challenges the notion that cardiovascular disease (CVD) often strikes without warning, and underscores the critical importance of maintaining optimal health metrics related to risk factors.

Key Findings: Risk Factors Are Almost Always Present

The study analyzed data from two large, long-term cohorts: the Korean National Health Insurance Service (KNHIS) and the U.S.-based Multi-Ethnic Study of Atherosclerosis (MESA). Together, these datasets tracked over 9.3 million adults in Korea and 6,800 adults in the U.S. for more than a decade.

Researchers examined four traditional risk factors — blood pressure, cholesterol, blood sugar, and smoking history — at levels considered "non-optimal," even if they did not meet the threshold for a formal medical diagnosis. A non-optimal risk factor is one that increases the likelihood of a negative health outcome — but can be changed or controlled through lifestyle changes or medication.

The findings were striking: more than 99 percent of individuals who developed coronary heart disease, heart failure, or stroke had at least one non-optimal risk factor before their event. Elevated blood pressure was the most common, affecting over 95 percent of participants in both countries. Elevated cholesterol and blood sugar levels, as well as smoking history, were also prevalent. Notably, more than 93 percent of participants had two or more risk factors, emphasizing the cumulative impact of these conditions.

These results highlight the importance of "primordial prevention," a proactive approach aimed at keeping risk factors well within optimal ranges to prevent the onset of disease. The study's authors argue that cardiovascular events rarely occur in individuals with truly ideal health metrics, reinforcing the need for early and sustained intervention.

The Role of Medical Monitoring

In addition to lifestyle modifications involving diet, weight management and regularly exercise, regular medical checkups are essential for monitoring key health indicators. Blood pressure, cholesterol, and blood sugar levels should be routinely assessed, and any abnormalities should be addressed promptly.

The near-universal presence of risk factors before cardiovascular events underscores the need for widespread public health initiatives focused on prevention. By adopting healthy habits and staying vigilant about risk factors, individuals can significantly reduce their likelihood of developing CVD, researchers emphasize.

Repeat COVID Infections Double Risks of ‘Long COVID’ in Children, Adolescents: NIH Study

A new, large-scale study reveals that children and adolescents who contract COVID-19 for a second time are twice as likely to develop “long COVID” — compared to those with only one infection. This finding, published in Lancet Infectious Diseases, challenges the common belief that COVID-19 is always mild in younger populations and that reinfections pose a lower risk.

Long COVID refers to a range of persistent symptoms and health problems that continue for weeks or months after the initial recovery from a COVID-19 infection. These symptoms can include fatigue, difficulty concentrating, shortness of breath, and other complications affecting various organs.

Key Findings

The research, funded by the National Institutes of Health (NIH), analyzed the electronic health records of over 465,000 young people between January 2022 and October 2023. The study found a significant increase in the risk for several serious health conditions following a second COVID-19 infection.

Among the most concerning findings was the increased risk of myocarditis, which is an inflammation of the heart muscle. This condition can weaken the heart and, in severe cases, be fatal. The study showed that the risk for myocarditis tripled after a second infection. Additionally, the likelihood of developing blood clots more than doubled. Other conditions associated with reinfection included kidney damage, abnormal heart rhythms, headaches, abdominal pain, and severe fatigue.

These results underscore the potential long-term consequences of repeat COVID-19 infections in children. According to study co-author Ravi Jhaveri, M.D., head of Pediatric Infectious Diseases at Ann & Robert H. Lurie Children's Hospital of Chicago, the findings highlight the importance of preventive measures.

“The results of this study further support one of the strongest reasons I give patients, families and physicians about getting vaccinated: More vaccines should lead to fewer infections, which should lead to less long COVID,” Dr. Jhaveri stated in a news release.

Future Directions

This investigation is the largest of its kind to examine long COVID after reinfection in children and is part of the broader NIH RECOVER Initiative. This initiative involves numerous U.S. children’s hospitals and aims to better understand the long-term effects of the virus.

Researchers say they will continue to track patient data over longer periods to see if newer COVID-19 variants alter these risk patterns. Future work will also explore strategies to help prevent these serious long-term effects in pediatric patients.

New Study Reveals Disparities in Cancer Survival Based on Location, Race

A new study led by researchers at the American Cancer Society (ACS) highlights significant differences in cancer survival rates across the United States. The findings show that individuals living in non-metropolitan areas, as well as Black individuals, generally face lower five-year survival rates compared to their counterparts in metropolitan areas and White individuals, states a news release from the ACS.

This research, published in the journal Cancer, points to critical gaps in healthcare access and treatment.

Study Methodology and Data Analysis

The study analyzed data for cancers diagnosed between 2015 and 2021. Researchers looked at five-year survival rates based on the stage of the cancer at diagnosis. The stages included:

• Localized: The cancer is confined to its original site.

• Regional: The cancer has spread to nearby tissues or lymph nodes.

• Distant: The cancer has metastasized, or spread, to distant parts of the body.

Results indicated that for all three stages, five-year survival rates were lower in non-metropolitan areas than in major cities for both Black and White individuals. Specifically, the survival gap ranged from 2 to 7 percentage points depending on the cancer stage.

Moreover, the study revealed that survival rates are consistently lower for Black persons compared to White persons across different cancer types and geographic locations. These disparities were especially pronounced for breast and colorectal cancers. The research also found that lower survival rates often corresponded with a lower likelihood of receiving recommended cancer treatments, such as surgery, chemotherapy, and radiation.

For example, the receipt of surgery for localized and regional-stage cancers was frequently lower for Black individuals than for White individuals, the ACS states.. In the case of lung cancer, this treatment gap was as large as 9 percentage points.

According to the study's lead author, Farhad Islami, M.D., these findings are linked to broader societal issues. “Lower survival rates for cancers with the same stage at diagnosis in non-metropolitan areas largely reflect disparities in receipt of quality cancer care due to inequities in social determinants of health, including lack of insurance coverage,” he stated in an ACS news release..

The study’s authors emphasize an urgent need to address these inequalities. As Dr. Islami noted in a news release: “Increasing access to cancer care to these historically marginalized populations is critically needed to mitigate disparities.”