Risk Factors for Cardiovascular Disease Cardiovascular diseases are the leading cause of illness and death in the world The majority of cases stem from atherosclerosis In coronary heart disease, the arteries to the heart muscle (myocardium) are narrowed leads to reduced blood supply to the heart can result in chest pain (angina pectoris) or other symptoms, typically triggered by physical exertion If a narrowed blood vessel is completely blocked by a blood clot, the area of the heart just beyond the blockage is denied oxygen and nourishment, resulting in a heart attack (MI) Dr.S Nayak

Ten risk factors help to predict the likelihood of CHD are Heredity Gender Age Cigarette smoking High blood pressure Diabetes Obesity Lack of physical activity Abnormal blood cholesterol Homocysteine levels The more risk factors a person has, the greater the likelihood of developing heart disease. Heredity, gender, and age cannot be modified, but the others can be influenced by the individual's behavior Dr.S Nayak

Major risk factors [can't be changed] Age — Over 83 percent of people who die of coronary heart disease are 65 or older Gender — Men have a greater risk of heart attack than women do, and they have attacks earlier in life Heredity (including Race) — Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians and some Asian Americans. This is partly due to higher rates of obesity and diabetes. Most people with a strong family history of heart disease have one or more other risk factors. Dr.S Nayak

Major risk factors [can be modified] Can be modified through treatment or control by changing lifestyle or taking medicine Tobacco smoke Smokers' risk of developing coronary heart disease is 2–4 times that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. High blood cholesterol  As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. Dr.S Nayak

Total blood cholesterol is classified by levels: Desirable: under 200 mg/dL 5 Borderline: 200-239 mg/dL High risk: 240 mg/dL and above LDL Cholesterol Optimal (ideal): Less than 100 mg/dL Near optimal/above optimal: 100-129 mg/dL Borderline high: 130-159 mg/dL High: 160-189 mg/dL (high risk) Very high: 190 mg/dL and above (very high risk) HDL Cholesterol Major heart disease risk factor: less than 40 mg/dL Protection against heart disease: 60 mg/dL and Above Dr.S Nayak

High blood pressure High blood pressure increases the heart's workload, causing the heart to thicken and become stiffer. It also increases stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times. Healthy adult [at rest] should have a systolic pressure below 120 and a diastolic pressure below 80 Physical inactivity An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. Physical activity can help control blood cholesterol, diabetes and obesity Dr.S Nayak

Obesity and overweight People who have excess body fat — especially at the waist are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases blood pressure and blood cholesterol and triglyceride levels, and lowers HDL ("good") cholesterol levels. It makes diabetes more likely to develop High Homocysteine The blood level of homocysteine is 15 micromoles/L. Increased level associated with cardiovascular disease Dr.S Nayak

Diabetes increases the risk of developing cardiovascular disease. Diabetes mellitus  Diabetes increases the risk of developing cardiovascular disease. Diabetes increases the risk of heart disease and stroke. The risk will be more if blood sugar is not well controlled. About three-quarters of people with diabetes die of some form of heart or blood vessel disease. It is important to work with healthcare provider to manage it and control any other risk factors you can. Other factors contribute to heart disease risk Stress may be a contributing factor. For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Dr.S Nayak

Ref: Essentials of Biochemistry Too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, It contributes to obesity, alcoholism, Experts say that moderate intake is an average of one to two drinks per day for men and one drink per day for women. One drink is defined as 1½ fluid ounces (fl oz) of 80-proof spirits (such as Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer. But drinking more than a moderate amount of alcohol can cause heart-related problems such as high blood pressure, stroke, irregular heartbeats, and cardiomyopathy (disease of the heart muscle) Ref: Essentials of Biochemistry Dr.S Nayak