Cardiovascular Risk Factors

National Cholesterol Education Program-Adult treatment panel III risk factors

Positive risk factors

• Age: male  45, female  55 or premature menopause without estrogen replacement therapy
• Family history of premature coronary heart disease: definite myocardial infarction or sudden death before age 55 years in male first-degree relative and before age 65 in female first-degree relative
• Current cigarette smoking
• Hypertension: blood pressure >140/90 mmHg, or an antihypertensive medication
• HDL cholesterol <40 mg/dL (1.03 mmol/L)*

Negative risk factors

• HDL cholesterol  60 mg/dL (1.55 mmol/L)

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Framingham Heart Study

• lifetime risk for individuals free of CHD at age 40 was 49 percent in men and 32 percent in women
• even those who were free from disease at age 70 had a lifetime risk of 35 percent and 24 percent in men and women, respectively

Four Major areas of CVD

• Coronary Artery Disease
• Cerebrovascular Disease
• Peripheral Vascular Disease
• Aortic atherosclerosis and thoracic or abdominal aortic aneurysm

2002 National Cholesterol Education Program report

• the presence of noncoronary atherosclerotic vascular disease was considered to carry the same risk for future cardiac events as the presence of CHD, thus classifying it as a CHD risk equivalent

  Nine potentially modifiable factors

• smoking
• dyslipidemia
• hypertension
• diabetes
• abdominal obesity
• psychosocial factors - Depression, anger, stress
• daily consumption of fruits and vegetables
• regular alcohol consumption
• regular physical activity.

Major CHD Risk Factors

• total cholesterol 240 mg/dL (6.22 mmol/L)
• systolic blood pressure 140 mmHg,
• diastolic blood pressure 90 mmHg,
• smoking, and
• diabetes.

Other CHD Risk Factors

• Sex
• Age
• Family History, Early MI in male <55yo, femal <65
• The following lipid abnormalities are associated with increased coronary risk
• Elevated LDL-cholesterol
• Low HDL-cholesterol
• Increased total-to-HDL-cholesterol ratio
• Hypertriglyceridemia
• Increased Lp(a)
• Increased non-HDL-cholesterol
• Increased apolipoprotein B (apo B; found primarily in LDL) and decreased apolipoprotein A-I (apo A-1; found in HDL)
• Small, dense LDL section on Small dense LDL (LDL phenotype B)