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)
| Class I |
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"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)" |
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"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: [1] [2]
- 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