Doctors have for the first time quantified the effect of the three major killers of middle-aged men: smoking, high blood pressure and high cholesterol. Men who smoke and fail to give up, or to control their blood pressure and cholesterol (where necessary) are sacrificing 10 to 15 years of their lives.
Results from the 40-year Whitehall study, landmark research into 19,000 civil servants begun in the late 1960s, shows that men who reached the age of 50 with all three risk factors lived on average to the age of 73, while those without any of the risks lived till 83. When other risks were included, such as diabetes and obesity, they found the least healthy lived until 70 on average, while the most healthy lived till 85.
Professor Peter Weissberg, medical director at the British Heart Foundation (BHF), which helped fund the research published in the British Medical Journal, said: "This important study puts a figure on the life-limiting effects of smoking, high blood pressure and high cholesterol. It provides a stark illustration of how these risk factors in middle age can reduce life expectancy."
He added: "The good news is that all of us can make changes to help us live a healthy life for longer, even after 50. We know that stopping smoking and reducing blood pressure and cholesterol, by lifestyle changes and/or tablets, can prevent the onset of heart disease – and these findings suggest it could make a decade of difference to our lives."
The finding comes after the Care Quality Commission (CQC) yesterday called for improvements in the treatment of heart disease. One in four GPs are failing to manage cholesterol levels or prescribe appropriately and an estimated 350,000 patients are missing out on the treatment they need, the commission said.
The CQC report called for changes in the way doctors are paid for treating heart disease to encourage them to identify more patients. Currently, GPs get maximum payments when they record acceptable cholesterol levels for 70 per cent of the patients on their register.
The CQC said further payments should be introduced to capture the one in three patients who may not be being seen by their GP once the practice has received its maximum payment under existing rules. It said action was needed to cut inequalities between people living in deprived areas and those in more affluent parts of the country. One reason for the discrepancy is that GPs do not follow "proven practice" consistently.
Researchers analysed the performance of 8,300 GP practices and 152 primary care trusts and found that, while incentivising GPs with specific payments to manage cholesterol levels in their patients was working, there were further improvement to be made.
Too many GPs were prescribing expensive branded statins when equally effective, cheaper non-branded ones were available. The CQC estimated that £62.5m could be saved if GPs mostly switched to prescribing generic statins.
Family doctors were not doing enough to record cases of cardiovascular disease in deprived areas. They were also less likely to prescribe nicotine-replacement products to patients.
CQC chair, Barbara Young, said: "This disease is likely to touch every single one of us at some point in our lives. We have to raise the bar of acceptable performance."
Average age of men who smoked, drank and ate poorly.
Average age of men without all three risk factors.