FOR RELEASE: 11:15 a.m. ET, Thursday March 25, 1999

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American Heart Association meeting report: Low educational level increases risk for congestive heart failure

ORLANDO, March 25 -- Not completing high school increases the risk of congestive heart failure almost as much as smoking and high blood pressure, according to a study presented today at the American Heart Association's epidemiology and prevention meeting.

Congestive heart failure (CHF) is an often-fatal condition in which a weakened heart muscle fails to pump enough blood to supply the body and its major organs. The number of individuals who die from CHF has grown rapidly in the United States. CHF is the only form of heart disease that is increasing in the population. Nearly five million Americans are now living with CHF and 400,000 new cases will be diagnosed this year.

Lead researcher Jiang He, M.D., Ph.D., of the Tulane School of Public Health and Tropical Medicine in New Orleans, says, ìThe same conditions that increase the risk for congestive heart failure are, in general, the same ones for heart attack and stroke -- high blood pressure, diabetes, smoking, obesity and physical inactivity. But one important addition that we found in this study is the amount of education.î

He and researchers at Tulane conducted a study to determine conditions that might contribute to CHF.

ìBy studying the factors that contribute to CHF, we can learn how modification of these factors might play a role in the prevention of CHF in the population,î says He.

In the study of 14,000 men and women, ages 25 to 74, researchers collected information about the participants' age, sex, race, blood levels of cholesterol, blood pressure and body mass index (a numerical way to measure body fat based on weight and height). Other factors, such as diabetes, educational level, physical inactivity, cigarette smoking and alcohol consumption, were included in the analysis. The low educational level was included because previous studies had found an association with kidney failure.

During nearly 20 years of follow-up study, 1,382 individuals developed CHF. The strongest risk factors for developing CHF were diabetes, high blood pressure, overweight, smoking and physical inactivity. Each one of these conditions increased the risk of CHF by 30 to 90 percent. In addition, a low education status -- having less than 12 years of schooling -- increased the risk by 35 percent.

ìMost likely, it isn't the lack of education itself, but the socio-economic conditions facing people with less education that increases the risk,î He adds. ìPeople with more education can be expected to be somewhat more knowledgeable about such health-related matters as nutrition and weight control. They also usually have higher incomes, which gives them better access to health care.

ìThe implications of our study are that there needs to be improvement in the treatment of diabetes and high blood pressure in low socio-economic status populations,î says He.

Co-authors are Lorraine Ogden, M.S., Suma Vupputuri, M.P.H., and Paul Whelton, M.D., of Tulane; and Catherine Loria, Ph.D., of the National Center for Health Statistics.

The research was presented at the American Heart Association 39th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

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NR99-1024 (Epi99/He)

Media Advisory: Dr. He can be reached at (504) 588-5165. (Please do not publish telephone number.) Q/nmr/epi99/newsreleases/He