Coronary heart disease risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Risk Equivalents in Primary Prevention
You are essentially considered to have the equivalent of coronary heart disease if you have any of the following:
- Aortic aneurysm
- Diabetes
- Framingham Risk Score (FRS) of > 20%
- Peripheral vascular disease (PVD) (defined as claudication, an Ankle Brachial Index (ABI) of < 0.9)
- Symptomatic carotid artery disease (defined as prior stroke or TIA)
CV Risk Factors in the Setting of Primary Prevention
- Cigarette smoking
- Family history of premature coronary artery disease (CAD)
- High LDL (defined as LDL > 130 mg /dl)
- Hypertension ( defined as a BP ≥140/90 mm Hg or if the patient is on antihypertensive drugs)
- Low HDL (defined as HDL < 40 mg/dL males, < 50 mg/dL in females)
- Older Age (men ≥45 years old; women ≥55 years old)
ACC / AHA Guidelines for Identification of Patients at Risk for Coronary Heart Disease[1]
Class I |
"1. Primary care providers should evaluate the presence and status of control of major risk factors for CHD for all patients at regular intervals (approximately every 3 to 5 years). (Level C)" |
"2. Ten-year risk (National Cholesterol Education Program [NCEP] global risk) of developing symptomatic CHD should be calculated for all patients who have 2 or more major risk factors to assess the need for primary prevention strategies. (Level B)" |
Complete List of Cardiac Risk Factors
In alphabetical order: [2] [3]
- ACE DD genotype
- Age
- Chronic Renal Failure
- Cigarette smoking
- Decreased apolipoprotein A1
- Decreased serum folate
- Diabetes Mellitus
- Family history of premature coronary artery disease
- HDL cholesterol > 130 mg/dl
- Hyperhomocysteinemia
- Hypertension
- Hypertriglyceridemia
- Immunosuppressive posttransplant
- Increased apolipoprotein B
- Increased C-reactive protein
- Increased fibrinogen
- Infections
- Insulin resistance syndrome
- Lack of supportive primary relationship
- LDL cholesterol < 40 mg/dl
- Low birth weight
- Metabolic syndrome
- Obesity
- Oral contraceptive use
- Sedentary living
- Syndrome X
- Type A personality
References
- ↑ 2012 Writing Committee Members. Jneid H, Anderson JL, Wright RS, Adams CD, Bridges CR; et al. (2012). "2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 126 (7): 875–910. doi:10.1161/CIR.0b013e318256f1e0. PMID 22800849.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X