A study has found that long-term exposure to the combination of both lower low-density lipoprotein cholesterol (LDL-C) and lower systolic blood pressure (SBP) is linked to a reduced lifetime risk of cardiovascular disease.

The relationship is dose-dependent, meaning that any combination of lower LDL-C and lower SBP was associated with a corresponding reduction in lifetime risk.

Even small declines in LDL-C and SBP can substantially diminish the likelihood of ever having a heart attack or stroke, the study shows.

For example, the combination of 0.3 mmol/L (14 mg/dL) lower LDL-C and 5 mmHg lower SBP was associated with a 50 per cent lower lifetime risk of cardiovascular disease.

Principal investigator Professor Brian Ference of the University of Cambridge, UK said: “Healthy eating and physical activity are effective ways to improve cardiovascular health.

“The best diet or exercise programme differs for each person. It is the one that produces the greatest reductions in both blood pressure and cholesterol for that person AND to which he or she can adhere because the benefits of the reductions accrue overtime.”

He added that the small modifications in LDL-C and SBP required to reduce risk can be achieved by eating healthily – including by following the Dietary Approaches to Stop Hypertension (DASH) diet. This is a lifelong approach to healthy eating designed to help treat or prevent high blood pressure.

Larger reductions in LDL-C and SBP with more aggressive lifestyle changes or other therapies can reduce lifetime risk of cardiovascular disease by 80 per cent and cardiovascular death by more than two-thirds (68 per cent).

The study included 438,952 participants of the UK Biobank who experienced a total of 24,980 major coronary events (defined as the first occurrence of non-fatal heart attack, ischaemic stroke, or coronary death).

The average age was 65.2 years and 54 per cent were female.

The researchers used genetic variants linked with lower LDL-C and SBP as instruments to randomly divide participants into groups with lifetime exposure to lower LDL-C, lower SBP, or both as compared to a reference group using a 2×2 factorial design.

They then compared the differences in plasma LDL-C, SBP and cardiovascular event rates between the groups to estimate associations with lifetime risk of cardiovascular disease.

Prof Ference said: “It is important to encourage patients and populations to invest in their future health.  Maintaining even small reductions in both LDL-C and SBP for prolonged periods of time can pay very big health dividends by dramatically reducing the lifetime risk of cardiovascular disease.”

The results were presented at this week’s European Society of Cardiology Congress 2019 and published in the Journal of the American Medical Association.