~ New MUHC Study Shows that Multiple Risk Factors Can Increase a
Person's Cardiovascular Age by up to Ten Years ~
MONTREAL, Nov. 26 /CNW/ - Despite the increasing evidence that managing
high cholesterol reduces cardiovascular events, many people do not achieve
recommended lipid levels(1). This is due, in part, to patients' lack of
understanding about their risk factors and the potential benefits of lifestyle
modifications and therapy(2).
A new study undertaken by the McGill University Health Centre (MUHC), the
Cardiovascular Health Evaluation to Improve Compliance and Knowledge Among
Uninformed Patients (CHECK-UP), now provides definitive evidence that
communicating the future risk of cardiovascular events to high-risk patients
improves the treatment of cardiovascular risk factors, such as high
cholesterol. CHECK-UP is the first successful study of its kind worldwide and
is published in this week's Archives of Internal Medicine.
"The economic burden of cardiovascular disease is substantial to the
Canadian healthcare system, but even more important are the devastating human
costs associated with the disease," says Dr. Steven Grover, lead author and
Director of the McGill Cardiovascular Health Improvement Program (CHIP). "The
CHECK-UP study shows that when Canadians become more actively involved in the
decisions surrounding their care, they are better equipped to manage their
risk for future cardiovascular events."
"Better knowledge of risk factors, how they impact a person's health and
how to manage them, particularly for people already living with heart disease,
can only be a good thing," says Dr. Jacques Genest, spokesperson for the Heart
and Stroke Foundation of Canada. "It's really important for Canadians to be
active participants in protecting their health."
Patients who entered the CHECK-UP study had high cholesterol requiring
treatment as per the Canadian Working Group Lipid Guidelines. Included were
those who had diabetes, established cardiovascular disease or multiple risk
factors for cardiovascular disease. The results of the study show that lipid
therapy is enhanced when patients are informed about their cardiovascular risk
and when they receive ongoing feedback from their doctor about the impact
lifestyle modifications and statin therapy has on their cardiovascular risk.
These patients saw a bigger drop in their lipid levels; in fact, the higher a
patient's cardiovascular risk, the greater their risk profile was impacted.
The computerized risk profiles used in the CHECK-UP study were based on
data from the Framingham Heart Study, and the Cardiovascular Life Expectancy
model previously published by the McGill research team. Each patient's future
risk of cardiovascular disease was based on their age, gender, blood pressure,
blood lipids, and whether or not they smoked, had diabetes or a previous
cardiac event such as a heart attack. For example, a 43-year-old male smoker
who is substantially overweight, with above-average cholesterol and blood
pressure levels, in actual fact has a cardiovascular age equivalent to that of
a 51-year-old. If all these risk factors were managed according to current
Canadian guidelines, he could reduce his cardiovascular age to that of a
"We are very excited about the results of the CHECK-UP study," says
Dr. Grover. "CHECK-UP is the first study of its kind in Canada to focus on the
importance of communicating calculated cardiovascular risk to patients who are
at high-risk for a cardiovascular event, such as a heart attack or stroke.
Discussing a patient's coronary risk and taking the necessary steps to manage
it is an important step in improving preventive care."
Cardiovascular disease, including heart disease and stroke, is the
leading cause of death in Canada(3). Research shows that approximately 80 per
cent of Canadians have at least one modifiable risk factor for cardiovascular
disease, such as high cholesterol, hypertension, obesity and a sedentary
About the CHECK-UP Study
The CHECK-UP study enrolled 230 primary care physicians and 2,687
patients who were at increased risk of a heart attack due to high blood lipid
levels. Among these subjects, 1,510 received a full report of their coronary
risk at each doctor's appointment over the course of a year. This report
contained their cardiovascular age(*) and their risk of developing a
cardiovascular event within eight years. These calculations are based on key
elements related directly to lifestyle, such as tobacco use, cholesterol level
and blood pressure, and allow doctors to demonstrate and quantify the precise
impact of lifestyle and medical treatment on a patient's health.
In the study, patients were randomized to receive usual care or ongoing
feedback at routine appointments regarding their calculated cardiovascular
risk and the change in this risk following lifestyle and/or statin therapy to
treat high cholesterol. At follow-up appointments, any subsequent improvements
in a patient's risk factors due to medication or lifestyle changes were used
to recalculate the patient's cardiovascular age. This gave both the patient
and his or her physician clear feedback on how the treatment had impacted the
patient's state of health.
The CHECK-UP study was supported by an unrestricted educational grant
from Pfizer Canada and designed in partnership with McGill University Health
McGill University Health Centre (MUHC)
The MUHC is a comprehensive academic health institution with an
international reputation for excellence in clinical programs, research and
teaching. The MUHC is a merger of five teaching hospitals affiliated with the
Faculty of Medicine at McGill University, the Montreal Children's, Montreal
General, Royal Victoria, and Montreal Neurological Hospitals, as well as the
Montreal Chest Institute. Building on the tradition of medical leadership of
the founding hospitals, the goal of the MUHC is to provide patient care based
on the most advanced knowledge in the health care field, and to contribute to
the development of new knowledge.
Pfizer Canada Inc
Pfizer Canada Inc. is the Canadian operation of Pfizer Inc., the world's
leading pharmaceutical company. Pfizer discovers, develops, manufactures and
markets prescription medicines for humans and animals. Pfizer's ongoing
research and development activities focus on a wide range of therapeutic areas
following our guiding aspiration: working for a healthier world. For more
information, visit www.pfizer.ca.
Note to editors:
(*) Cardiovascular age is calculated as the patient's age minus the
difference between their estimated remaining life expectancy and the
average remaining life expectancy of life expectancy of Canadians the
same age and sex(5).
(1) Scandinavian Simvastatin Survival Study Group. Randomised trial of
cholesterol lowering in 4444 patients with coronary heart disease:
The Scandinavian Simvastatin Survival Study (4S). Lancet 1994:
(2) Benner, JS, Glynn, RJ, Mogun, H, Neumann, PJ, Weinstein, MC, Avorn,
J. Long-term persistence in use of statin therapy in elderly
patients. JAMA 2002;228: 462-67.
(3) Health Canada, June 2007. Available at http://www.hc-sc.gc.ca/dc-
(4) May 2003. The Growing Burden of Heart Disease and Stroke in Canada.
Heart and Stroke Foundation of Canada.
(5) Grover, SA., Lowensteyn I, Esrey, K., Steinert, Y., Joseph, L.,
Abrahamowicz, M. How accurately do Canadian physicians assess the
coronary risk of their patients? The preliminary results of the
Coronary Health Assessment Study (CHAS). BMJ 1995;310: 975-78.
For further information:
For further information: Isabelle Kling, McGill University Health
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